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The procedure described by CPT® Code 33736 refers to an atrial septectomy or septostomy performed through an open heart technique with the assistance of cardiopulmonary bypass. This surgical intervention is primarily indicated for patients suffering from transposition anomalies of the great vessels, where the normal flow of oxygenated and deoxygenated blood is disrupted. The aim of the procedure is to create an opening in the atrial septum, which is the wall separating the right and left atria of the heart, thereby improving oxygen saturation levels in the bloodstream. The operation is conducted under general anesthesia and requires the use of cardiopulmonary bypass to maintain circulation and oxygenation while the heart is temporarily stopped. The surgical approach involves a median sternotomy, which provides direct access to the heart, allowing the surgeon to excise the atrial septum effectively. This procedure is particularly beneficial for patients with a thick atrial septum, as it facilitates better management of their condition and enhances overall cardiac function.
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The atrial septectomy or septostomy procedure, as described by CPT® Code 33736, is indicated for specific conditions that necessitate the improvement of oxygen saturation in patients. The following are the primary indications for this procedure:
The procedure for CPT® Code 33736 involves several critical steps that ensure the successful execution of the atrial septectomy or septostomy. The following outlines the procedural steps in detail:
Post-procedure care following an atrial septectomy or septostomy involves monitoring the patient for any complications and ensuring proper recovery. Patients are typically observed in a postoperative setting where vital signs are closely monitored. The placement of chest tubes allows for the drainage of excess fluid, which is essential for preventing complications such as pleural effusion. The expected recovery period may vary depending on the individual patient's condition and response to surgery. Follow-up care is crucial to assess the effectiveness of the procedure in improving oxygen saturation and overall cardiac function. Additionally, patients may require further evaluations and management of their underlying conditions.
| Short Descr | REVISION OF HEART CHAMBER | Medium Descr | ATRIAL SEPTECTOMY/SEPTOSTOMY OPEN HEART W/BYPASS | Long Descr | Atrial septectomy or septostomy; open heart 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) | 33924 | Addon Code MPFS Status: Active Code APC C CPT Assistant Article Ligation and takedown of a systemic-to-pulmonary artery shunt, performed in conjunction with a congenital heart procedure (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). | 82 | Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s). | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery |
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| 1994-01-01 | Added | First appearance in code book in 1994. |
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