© Copyright 2025 American Medical Association. All rights reserved.
The procedure described by CPT® Code 33501 involves the surgical repair of a coronary arteriovenous or arteriocardiac chamber fistula without the use of cardiopulmonary bypass. A coronary arteriovenous fistula is defined as an abnormal connection between a coronary artery and either a systemic or pulmonary vein, which can lead to various complications due to altered blood flow. Similarly, a coronary arteriocardiac chamber fistula refers to an abnormal connection between a coronary artery and a heart chamber, which can also disrupt normal cardiac function. The surgical approach typically requires a median sternotomy, which is an incision made along the sternum to provide access to the heart. During the procedure, the surgeon identifies the feeding coronary artery and the specific site where the fistula connects to the artery. Additionally, the pathway of the fistula and its drainage site into either a vein or a cardiac chamber are carefully mapped out. The absence of cardiopulmonary bypass in this procedure indicates that the heart continues to function normally during the repair, allowing for a more straightforward surgical approach. The closure of the fistula is performed based on its drainage site, either by suturing the venous end or by opening the cardiac chamber to close the drainage site with sutures or a patch. If the feeding vessel is significantly large, the coronary artery may also be incised to facilitate the closure of the fistula. This procedure is critical for restoring normal hemodynamics and preventing potential complications associated with these types of fistulas.
© Copyright 2025 Coding Ahead. All rights reserved.
The procedure described by CPT® Code 33501 is indicated for the repair of coronary arteriovenous or arteriocardiac chamber fistulas. These conditions may present with various symptoms or complications, including:
The surgical procedure for repairing a coronary arteriovenous or arteriocardiac chamber fistula without cardiopulmonary bypass involves several critical steps:
After the completion of the procedure, patients are typically monitored for any signs of complications, such as bleeding or infection. Recovery may involve a stay in the hospital for observation, especially to assess cardiac function and ensure that the repair is successful. Patients may be advised on activity restrictions and follow-up appointments to monitor their recovery and heart health. The expected recovery time can vary based on individual patient factors and the complexity of the procedure, but most patients can anticipate a gradual return to normal activities as they heal.
| Short Descr | REPAIR HEART VESSEL FISTULA | Medium Descr | RPR CORONARY AV/ARTERIOCAR CHMBR FSTL W/O BYPASS | Long Descr | Repair of coronary arteriovenous or arteriocardiac chamber fistula; without cardiopulmonary 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) | 2 - Co-surgeons permitted and no documentation required if the two- specialty requirement is met. | 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). | 53 | Discontinued procedure: under certain circumstances, the physician or other qualified health care professional may elect to terminate a surgical or diagnostic procedure. due to extenuating circumstances or those that threaten the well being of the patient, it may be necessary to indicate that a surgical or diagnostic procedure was started but discontinued. this circumstance may be reported by adding modifier 53 to the code reported by the individual for the discontinued procedure. note: this modifier is not used to report the elective cancellation of a procedure prior to the patient's anesthesia induction and/or surgical preparation in the operating suite. for outpatient hospital/ambulatory surgery center (asc) reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 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 | LT | Left side (used to identify procedures performed on the left side of the body) | RT | Right side (used to identify procedures performed on the right side of the body) |
|
Date
|
Action
|
Notes
|
|---|---|---|
| 1993-01-01 | Added | First appearance in code book in 1993. |
Get instant expert-level medical coding assistance.