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An exploratory cardiotomy, also known as an exploratory atriotomy or ventriculotomy, is a surgical procedure that involves making an incision in the heart to investigate and address specific issues within its chambers. This procedure is particularly focused on the removal of any foreign bodies or thrombi (blood clots) that may be present in the atria or ventricles of the heart. The operation typically begins with a midline sternotomy, which is an incision made along the sternum to provide access to the heart. In cases where cardiopulmonary bypass is not required, the procedure is performed directly on the heart. The surgeon carefully incises the heart wall, either through the atrium or ventricle, to gain access to the interior of the heart chamber that may be compromised. Once inside, the surgeon inspects the heart chamber for any abnormalities, such as foreign objects or thrombi, and removes them as necessary. After the procedure, the incisions in the heart wall are closed, and if cardiopulmonary bypass was utilized, it is subsequently terminated. The procedure concludes with the placement of chest tubes if needed and the closure of the chest wall incision. This code, CPT® 33310, is specifically designated for exploratory cardiotomy performed without the use of cardiopulmonary bypass, while CPT® 33315 is used when bypass is involved.
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The exploratory cardiotomy procedure is indicated for various conditions that necessitate direct access to the heart chambers for diagnosis or treatment. The following are the explicitly provided indications for performing this procedure:
The procedure for exploratory cardiotomy involves several critical steps that ensure effective access to the heart and the successful removal of any identified issues. The following procedural steps are outlined:
Post-procedure care following an exploratory cardiotomy includes monitoring the patient for any signs of complications, such as bleeding or infection. The patient may require pain management and supportive care as they recover from the surgery. The placement of chest tubes, if performed, will be monitored for proper drainage. The expected recovery period will vary based on the individual patient's condition and the extent of the procedure performed. Follow-up appointments will be necessary to assess the healing process and ensure that no further interventions are required.
| Short Descr | EXPLORATORY HEART SURGERY | Medium Descr | CARDIOT EXPL W/RMVL FB ATR/VENTR THRMB W/O BYP | Long Descr | Cardiotomy, exploratory (includes removal of foreign body, atrial or ventricular thrombus); without bypass | Status Code | Active Code | Global Days | 090 - Major Surgery | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 2 - Payment restriction for assistants at surgery does not apply to this procedure... | Co-Surgeons (62) | 1 - Co-surgeons could be paid, though supporting documentation is required... | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Inpatient Procedures, not paid under OPPS | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P2F - Major procedure, cardiovascular-Other | MUE | 1 | CCS Clinical Classification | 49 - Other OR heart procedures |
This is a primary code that can be used with these additional add-on codes.
| 33257 | Addon Code MPFS Status: Active Code APC C Illustration for Code Operative tissue ablation and reconstruction of atria, performed at the time of other cardiac procedure(s), limited (eg, modified maze procedure) (List separately in addition to code for primary procedure) | 33258 | Addon Code MPFS Status: Active Code APC C Illustration for Code Operative tissue ablation and reconstruction of atria, performed at the time of other cardiac procedure(s), extensive (eg, maze procedure), without cardiopulmonary bypass (List separately in addition to code for primary procedure) |
| 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 62 | Two surgeons: when 2 surgeons work together as primary surgeons performing distinct part(s) of a procedure, each surgeon should report his/her distinct operative work by adding modifier 62 to the procedure code and any associated add-on code(s) for that procedure as long as both surgeons continue to work together as primary surgeons. each surgeon should report the co-surgery once using the same procedure code. if additional procedure(s) (including add-on procedure(s) are performed during the same surgical session, separate code(s) may also be reported with modifier 62 added. note: if a co-surgeon acts as an assistant in the performance of additional procedure(s), other than those reported with the modifier 62, during the same surgical session, those services may be reported using separate procedure code(s) with modifier 80 or modifier 82 added, as appropriate. | 78 | Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.) | 82 | Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s). | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | GC | This service has been performed in part by a resident under the direction of a teaching physician | RT | Right side (used to identify procedures performed on the right side of the body) | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| 2004-01-01 | Changed | Code description changed. |
| Pre-1990 | Added | Code added. |
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