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A ventricular septal defect (VSD) is a congenital heart defect characterized by one or more abnormal openings in the septum that separates the heart's ventricles. This condition can lead to significant hemodynamic changes and requires surgical intervention for correction. The procedure associated with CPT® Code 33675 involves the closure of multiple VSDs through a surgical approach that typically requires an incision in the chest to access the heart. During the operation, the pericardium, which is the fibrous sac surrounding the heart, is incised, and a patch may be harvested if necessary for the repair. Cardiopulmonary bypass is initiated to maintain circulation and oxygenation while the heart is being operated on. The multiple VSDs are repaired through an incision made in the right atrium, pulmonary artery, or the outflow tract of the right ventricle, known as the infundibulum. The defects can be closed using sutures or by placing a patch over the openings. If a patch is utilized, it may consist of synthetic material or a previously harvested piece of pericardium, which is sutured securely over the defects to restore normal heart function. After the repairs are completed, the access incision is closed, and cardiopulmonary bypass is discontinued. Chest tubes are then placed to facilitate drainage, and the chest incision is finally closed, marking the completion of the procedure.
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The closure of multiple ventricular septal defects (VSDs) is indicated in patients presenting with the following conditions:
The procedure for the closure of multiple VSDs involves several critical steps:
Post-procedure care involves monitoring the patient for any complications, ensuring proper drainage through the chest tubes, and managing pain. Patients are typically observed in a recovery unit until stable. Follow-up imaging may be required to assess the success of the VSD closure and to monitor for any potential complications such as residual defects or pulmonary hypertension. The recovery period may vary based on the patient's overall health and the complexity of the surgery performed.
| Short Descr | CLOSE MULT VSD | Medium Descr | CLOSURE MULTIPLE VENTRICULAR SEPTAL DEFECTS | Long Descr | Closure of multiple ventricular septal defects; | 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) | P2B - Major procedure, cardiovascular-Aneurysm repair | 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) |
| GC | This service has been performed in part by a resident under the direction of a teaching physician |
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| 2010-01-01 | Changed | Code description changed. |
| 2007-01-01 | Added | First appearance in code book in 2007. |
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