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The procedure described by CPT® Code 33973 involves the insertion of an intra-aortic balloon assist device (IABP) through the ascending aorta, a critical intervention often performed in patients experiencing severe cardiac conditions. The aorta, which is the main artery supplying blood to the body, is accessed through a surgical procedure known as median sternotomy, where the chest is opened to provide direct access to the heart and major blood vessels. During this procedure, a side-biting clamp is applied to the ascending aorta to control blood flow, allowing for a safe incision in the aorta. The IABP is introduced using the Seldinger technique, a method that involves the use of a guide wire to facilitate the placement of the catheter. The IABP is positioned distal to the left subclavian artery, which is crucial for ensuring that the device functions effectively to augment coronary perfusion. The device is secured in place with purse-string sutures, which help to prevent any leakage of blood around the catheter. In some cases, a synthetic graft may be used to create an end-to-side anastomosis with the aorta, providing an alternative pathway for the IABP. Once the IABP is in place, it is connected to a balloon pump console, which controls the inflation and deflation of the balloon. This inflation occurs at the start of diastole, enhancing blood flow to the coronary arteries, while deflation occurs during systole, assisting the heart in ejecting blood and improving overall cardiac output. The procedure is designed to reduce the workload on the left ventricle, thereby decreasing its oxygen demand. The subsequent removal of the IABP, as described in CPT® Code 33974, involves careful closure of the aorta and management of the surgical site to ensure patient safety and recovery.
© Copyright 2025 Coding Ahead. All rights reserved.
The insertion of an intra-aortic balloon assist device (IABP) through the ascending aorta, as described by CPT® Code 33973, is indicated for patients experiencing specific cardiac conditions that necessitate temporary mechanical support. The following conditions may warrant this procedure:
The procedure for the insertion of the intra-aortic balloon assist device involves several critical steps to ensure proper placement and functionality of the device:
After the insertion of the intra-aortic balloon assist device, careful post-procedure management is essential for patient safety and recovery. The patient is typically monitored closely in a critical care setting to assess hemodynamic stability and the effectiveness of the IABP. Vital signs, including blood pressure and heart rate, are continuously monitored to ensure that the device is functioning correctly. Additionally, the surgical site is inspected for any signs of complications, such as bleeding or infection. Patients may experience some discomfort at the incision site, and pain management strategies will be implemented as needed. The IABP is usually maintained for a limited duration, depending on the patient's clinical status and response to treatment. Once the underlying cardiac condition stabilizes, the IABP will be removed, and the aorta will be repaired as described in CPT® Code 33974. This removal process involves careful closure of the aorta and monitoring for any potential complications during recovery.
| Short Descr | INSERT BALLOON DEVICE | Medium Descr | INSJ I-AORT BALO ASSIST DEV VIA ASCENDING AORTA | Long Descr | Insertion of intra-aortic balloon assist device through the ascending aorta | Status Code | Active Code | Global Days | 000 - Endoscopic or Minor Procedure | 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 |
| 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). | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 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.) | 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 | GC | This service has been performed in part by a resident under the direction of a teaching physician |
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| 2022-01-01 | Changed | AMA guideline removed. |
| 2017-01-01 | Changed | Guidelines Changed. |
| 1994-01-01 | Added | First appearance in code book in 1994. |
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