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The procedure described by CPT® Code 33915 refers to a pulmonary artery embolectomy performed without the use of cardiopulmonary bypass. This surgical intervention is aimed at removing an embolus, which is a blockage in the pulmonary arteries that can impede blood flow to the lungs. The procedure typically involves accessing the pulmonary arteries through a median sternotomy or thoracotomy, which are surgical approaches that allow the surgeon to reach the heart and lungs. During the operation, the main pulmonary artery and its branches are carefully dissected to free them from surrounding tissues, ensuring that the area is adequately exposed for the removal of the embolus. It is important to note that if cardiopulmonary bypass were to be utilized, a different code (CPT® Code 33910) would be applicable. The distinction between these two codes is crucial for accurate medical coding and billing, as it reflects the complexity and the specific techniques employed during the procedure.
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The pulmonary artery embolectomy procedure is indicated for patients who present with a pulmonary embolism, which is a blockage in the pulmonary arteries typically caused by blood clots. This condition can lead to significant respiratory distress and compromised oxygenation. The procedure is performed when the embolus is large enough to cause severe symptoms or when other treatments, such as anticoagulation therapy, are deemed insufficient or inappropriate. The urgency of the situation often dictates the need for surgical intervention to restore normal blood flow to the lungs and prevent further complications.
The pulmonary artery embolectomy without cardiopulmonary bypass involves several critical steps to ensure the successful removal of the embolus. First, the surgical team accesses the pulmonary arteries through a median sternotomy or thoracotomy, which allows for adequate exposure of the heart and lungs. Once access is achieved, the main pulmonary artery and its branches are meticulously dissected free from surrounding tissues. This dissection is crucial as it provides the necessary visibility and access to the embolus. If cardiopulmonary bypass were to be utilized, the aorta and the superior and inferior vena cava would be cannulated, and bypass would be established; however, in this case, the procedure is performed without such support. The pericardium is then incised, and the main pulmonary artery is opened to facilitate the removal of the embolus. The incision may be extended into the right and/or left pulmonary arteries as needed to locate and effectively remove the blockage. This careful approach ensures that the embolus is completely excised, restoring normal blood flow through the pulmonary arteries.
After the pulmonary artery embolectomy, patients are typically monitored closely for any signs of complications, such as bleeding or respiratory distress. The recovery process may involve supportive care, including oxygen therapy and pain management, to ensure the patient's comfort and facilitate healing. The surgical team will assess the patient's respiratory function and overall stability before determining the appropriate discharge plan. Follow-up appointments are essential to monitor the patient's recovery and to address any potential issues that may arise post-surgery.
| Short Descr | REMOVE LUNG ARTERY EMBOLI | Medium Descr | PULMONARY ARTERY EMBOLECTOMY W/O CARD BYPASS | Long Descr | Pulmonary artery embolectomy; 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) | 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 | 61 - Other OR procedures on vessels other than head and neck |
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). | 53 | Discontinued procedure: under certain circumstances, the physician or other qualified health care professional may elect to terminate a surgical or diagnostic procedure. due to extenuating circumstances or those that threaten the well being of the patient, it may be necessary to indicate that a surgical or diagnostic procedure was started but discontinued. this circumstance may be reported by adding modifier 53 to the code reported by the individual for the discontinued procedure. note: this modifier is not used to report the elective cancellation of a procedure prior to the patient's anesthesia induction and/or surgical preparation in the operating suite. for outpatient hospital/ambulatory surgery center (asc) reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 78 | Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.) | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | GC | This service has been performed in part by a resident under the direction of a teaching physician | LT | Left side (used to identify procedures performed on the left side of the body) | RT | Right side (used to identify procedures performed on the right side of the body) |
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| Pre-1990 | Added | Code added. |
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