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The procedure described by CPT® Code 33503 involves the surgical repair of an anomalous coronary artery that originates from the pulmonary artery, utilizing a graft without the use of cardiopulmonary bypass. Normally, coronary arteries arise from the ascending aorta, positioned just above the aortic valve, and any deviation from this standard anatomical configuration is classified as an anomaly. In cases where the coronary artery arises from the pulmonary artery, various surgical interventions may be required depending on the specific type of anomaly present. The surgical approach typically involves a median sternotomy or a posterolateral thoracotomy to gain access to the heart. During the procedure, the surgeon will repair the anomalous coronary artery by creating a bypass graft that redirects blood flow from the aorta to the coronary artery, effectively restoring normal blood supply. This technique is performed off-pump, meaning that the heart continues to beat during the surgery, which is a critical aspect of this procedure. The use of grafts, such as the internal mammary artery or saphenous vein, is common, and careful dissection and ligation of the graft site are essential steps in the process. Ultimately, this procedure aims to correct the abnormal blood flow and ensure adequate perfusion to the heart muscle, thereby improving the patient's overall cardiac function.
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The procedure coded as CPT® 33503 is indicated for patients with an anomalous coronary artery that originates from the pulmonary artery. This condition can lead to various complications, including inadequate blood supply to the heart muscle, which may result in ischemia or other cardiac issues. The specific indications for performing this surgical repair include:
The surgical procedure for CPT® 33503 involves several critical steps to repair the anomalous coronary artery. The following procedural steps are performed:
After the completion of the procedure, patients typically require monitoring in a postoperative setting to assess recovery and ensure there are no complications. Expected post-procedure care includes managing pain, monitoring vital signs, and ensuring proper heart function. Patients may also need to follow specific guidelines for activity restrictions and medication management as they recover. The overall recovery period can vary based on individual patient factors and the complexity of the surgery performed.
| Short Descr | CORONARY ARTERY GRAFT | Medium Descr | RPR ANOM CORONARY ARTERY PULM ART ORIGIN GRAFT | Long Descr | Repair of anomalous coronary artery from pulmonary artery origin; by graft, 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) | 0 - Payment restriction for assistants at surgery applies 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). | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery |
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| 2006-01-01 | Changed | Code description changed. |
| Pre-1990 | Added | Code added. |
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