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The procedure described by CPT® Code 33502 involves the surgical repair of an anomalous coronary artery that originates from the pulmonary artery. In a normal anatomical configuration, coronary arteries arise from the ascending aorta, specifically from the sinuses of Valsalva, which are positioned above the aortic valve. However, in cases of anomalous coronary artery origins, the arteries may arise from a nonfacing or distant sinus, leading to various potential complications. The surgical approach to address this anomaly is contingent upon the specific characteristics of the coronary artery's abnormality. The procedure typically requires a median sternotomy or a posterolateral thoracotomy to gain access to the heart. During the operation, the surgeon identifies the anomalous coronary artery and places two ligatures above its origin in the pulmonary artery to effectively halt blood flow through the anomalous vessel. This ligation is crucial to prevent any adverse effects that may arise from the abnormal blood supply. The procedure is distinct from other related surgical interventions, such as those described in CPT® Codes 33503 and 33504, which involve different methods of repair, including bypass grafting with or without cardiopulmonary bypass. Overall, the ligation of the anomalous coronary artery is a critical step in restoring normal coronary circulation and ensuring the patient's cardiovascular health.
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The procedure described by CPT® Code 33502 is indicated for patients with an anomalous coronary artery that originates from the pulmonary artery. This condition can lead to various complications, including myocardial ischemia or infarction, due to inadequate blood supply to the heart muscle. The surgical intervention is necessary to correct the abnormal blood flow and prevent potential cardiac events associated with this anomaly.
The surgical procedure for CPT® Code 33502 involves several critical steps to effectively repair the anomalous coronary artery. First, the surgeon performs a median sternotomy or a posterolateral thoracotomy to gain access to the heart. This initial step is essential for visualizing the cardiac structures and the anomalous artery. Once the heart is exposed, the surgeon identifies the anomalous coronary artery that is originating from the pulmonary artery. Following identification, the surgeon places two ligatures around the anomalous artery, specifically positioned just above its origin in the pulmonary artery. This ligation is performed to occlude the blood flow through the anomalous vessel, thereby preventing any adverse effects associated with its abnormal connection. The careful placement of these ligatures is crucial to ensure that the anomalous artery is effectively isolated from the pulmonary circulation, thus restoring normal blood flow dynamics to the coronary arteries.
After the completion of the ligation procedure, the patient will typically be monitored in a postoperative setting for any signs of complications. The expected recovery period may vary depending on the individual patient's condition and the extent of the surgery. Postoperative care may include pain management, monitoring of vital signs, and assessment of cardiac function to ensure that the heart is functioning properly after the intervention. Patients may also require follow-up evaluations to assess the success of the procedure and to monitor for any potential complications that could arise from the anomalous coronary artery repair.
| Short Descr | CORONARY ARTERY CORRECTION | Medium Descr | RPR ANOM CORONARY ART PULM ART ORIGIN LIGATION | Long Descr | Repair of anomalous coronary artery from pulmonary artery origin; by ligation | 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) | 34714 | Addon Code MPFS Status: Active Code APC N ASC N1 Open femoral artery exposure with creation of conduit for delivery of endovascular prosthesis or for establishment of cardiopulmonary bypass, by groin incision, unilateral (List separately in addition to code for primary procedure) | 34716 | Addon Code MPFS Status: Active Code APC N ASC N1 Open axillary/subclavian artery exposure with creation of conduit for delivery of endovascular prosthesis or for establishment of cardiopulmonary bypass, by infraclavicular or supraclavicular incision, unilateral (List separately in addition to code for primary procedure) | 34833 | Addon Code Resequenced Code MPFS Status: Active Code APC C CPT Assistant Article Open iliac artery exposure with creation of conduit for delivery of endovascular prosthesis or for establishment of cardiopulmonary bypass, by abdominal or retroperitoneal incision, unilateral (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). | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | GC | This service has been performed in part by a resident under the direction of a teaching physician |
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| 2006-01-01 | Changed | Code description changed. |
| Pre-1990 | Added | Code added. |
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