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Excision of coarctation of the aorta, as described by CPT® Code 33845, refers to a surgical procedure aimed at correcting a narrowing (coarctation) of the aorta, which is the main artery that carries blood from the heart to the rest of the body. This condition typically occurs between the arterial branches that supply blood to the upper body and those that supply the lower body, leading to an imbalance in blood flow. The upper body receives an increased volume of blood, while the lower body experiences reduced blood flow, which can result in various complications. The surgical approach involves a posterolateral thoracotomy, which is an incision made in the chest to access the aorta. During the procedure, the parietal pleura, a membrane lining the chest cavity, is incised to allow for better access to the aorta. The surgeon carefully dissects surrounding tissues to expose critical structures, including the transverse aortic arch, left subclavian artery, ligamentum or ductus arteriosus, descending aorta, and intercostal collateral vessels. To perform the excision safely, proximal and distal control of the aorta is achieved using vascular clamps, and the subclavian artery is also clamped while controlling the intercostal collaterals with vessel loops. If a patent ductus arteriosus is present, it is managed with transfixing sutures, and a stay suture is placed in the aortic isthmus before ligation. The procedure culminates in the resection of the narrowed segment of the aorta, followed by the insertion of a synthetic tube graft to connect the upper and lower segments of the aorta, thereby restoring normal blood flow.
© Copyright 2025 Coding Ahead. All rights reserved.
The procedure described by CPT® Code 33845 is indicated for patients diagnosed with coarctation of the aorta, which is characterized by a narrowing of the aorta that can lead to significant hemodynamic changes. The following conditions may warrant this surgical intervention:
The surgical procedure for excision of coarctation of the aorta with graft involves several critical steps to ensure successful correction of the defect:
Post-procedure care following the excision of coarctation of the aorta with graft involves monitoring the patient for any complications and ensuring proper recovery. Patients are typically observed in a postoperative setting for signs of bleeding, infection, or any cardiovascular complications. Pain management is also an essential aspect of post-operative care. The recovery period may vary depending on the individual patient's condition and the extent of the surgery performed. Follow-up appointments are necessary to assess the success of the procedure and to monitor the function of the graft. Additionally, patients may require imaging studies to evaluate the aorta and ensure that there are no further obstructions or complications.
| Short Descr | EXCISION COA W/GRAFT | Medium Descr | EXCISION COARCTATION AORTA W/WO PDA W/GRAFT | Long Descr | Excision of coarctation of aorta, with or without associated patent ductus arteriosus; with graft | 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 | 52 - Aortic resection, replacement or anastomosis |
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). | 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). |
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| 2025-01-01 | Changed | Short Description changed. |
| Pre-1990 | Added | Code added. |
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