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The procedure described by CPT® Code 33504 involves the surgical repair of an anomalous coronary artery that originates from the pulmonary artery, utilizing a graft and requiring cardiopulmonary bypass. Normally, coronary arteries emerge from the ascending aorta, positioned just above the aortic valve, specifically from the facing sinuses of Valsalva. However, in cases of anomalous coronary artery origins, the arteries may arise from a nonfacing or distant sinus, leading to various congenital heart defects. The surgical approach to address these anomalies is contingent upon the specific characteristics of the coronary artery's abnormality. In this procedure, a median sternotomy or a posterolateral thoracotomy is performed to gain access to the heart. The surgical team identifies the anomalous coronary artery and employs cardiopulmonary bypass to facilitate the repair process. This method allows for a controlled environment in which the heart can be temporarily stopped, ensuring that the surgeon can work on the coronary artery without the complications of blood flow. The procedure aims to restore normal blood supply to the coronary artery by redirecting it from the aorta rather than the pulmonary artery, thereby correcting the abnormal communication and ensuring proper cardiac function.
© Copyright 2025 Coding Ahead. All rights reserved.
The procedure described by CPT® Code 33504 is indicated for patients with an anomalous coronary artery that originates from the pulmonary artery. This condition can lead to significant cardiovascular complications, including ischemia and myocardial infarction, due to inadequate blood supply to the heart muscle. The repair is necessary to restore normal coronary circulation and prevent further cardiac events.
The surgical procedure for CPT® Code 33504 involves several critical steps, all performed under cardiopulmonary bypass to ensure a bloodless field and optimal conditions for repair.
After the completion of the procedure, patients are typically monitored in a postoperative care unit. The recovery process may involve close observation for any complications related to the surgery or the cardiopulmonary bypass. Patients may require pain management and support for respiratory function as they recover from anesthesia. The length of the hospital stay can vary based on individual recovery, but patients are generally expected to follow up with their healthcare provider for ongoing assessment of cardiac function and overall health.
| Short Descr | CORONARY ARTERY GRAFT | Medium Descr | RPR ANOM CORONARY ART PULM ART ORIGIN GRF W/BYP | Long Descr | Repair of anomalous coronary artery from pulmonary artery origin; by graft, with 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) | 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) | 33259 | 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), with 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). | 55 | Postoperative management only: when 1 physician or other qualified health care professional performed the postoperative management and another performed the surgical procedure, the postoperative component may be identified by adding modifier 55 to the usual procedure number. | 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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