© Copyright 2025 American Medical Association. All rights reserved.
The procedure described by CPT® Code 33974 involves the removal of an intra-aortic balloon assist device (IABP) from the ascending aorta, which may include the repair of the ascending aorta itself, with or without the use of a graft. The intra-aortic balloon pump is a mechanical device used to support the heart's function by improving coronary perfusion and decreasing the workload of the heart. This is achieved by inflating the balloon during diastole, which augments blood flow to the coronary arteries, and deflating it during systole, which assists in the ejection of blood from the left ventricle. The procedure typically begins with a median sternotomy to expose the aorta, followed by the placement of a side-biting clamp to facilitate access to the ascending aorta. The IABP is introduced using the Seldinger technique, which is a method for gaining access to the vascular system, and is positioned distal to the left subclavian artery. The device is secured in place with purse-string sutures. In some cases, a synthetic graft may be anastomosed to the aorta in an end-to-side manner to facilitate the introduction of the IABP. The removal of the IABP involves either closing the aorta with sutures or using a patch or tube graft, depending on how the device was initially placed. This procedure is critical for patients who require temporary circulatory support and is performed in a controlled surgical environment to ensure patient safety and optimal outcomes.
© Copyright 2025 Coding Ahead. All rights reserved.
The procedure described by CPT® Code 33974 is indicated for patients who have undergone placement of an intra-aortic balloon assist device (IABP) and require its removal. The specific indications for this procedure may include:
The procedure for the removal of the intra-aortic balloon assist device and repair of the ascending aorta involves several critical steps:
After the removal of the intra-aortic balloon assist device and the repair of the ascending aorta, patients typically require close monitoring in a postoperative setting. Expected recovery may involve observation for any signs of complications, such as bleeding or infection at the surgical site. Patients may also need to be monitored for hemodynamic stability and cardiac function as they recover from the procedure. The surgical team will provide specific post-operative care instructions, which may include pain management, activity restrictions, and follow-up appointments to assess the healing process and ensure proper recovery.
| Short Descr | REMOVE INTRA-AORTIC BALLOON | Medium Descr | RMVL ASCENDING-AORTA BALO DEV W/RPR ASCEND-AORTA | Long Descr | Removal of intra-aortic balloon assist device from the ascending aorta, including repair of the ascending aorta, with or without 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) | 1 - Statutory payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | 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. | 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.) | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | FS | Split (or shared) evaluation and management visit | GC | This service has been performed in part by a resident under the direction of a teaching physician | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter | XP | Separate practitioner, a service that is distinct because it was performed by a different practitioner |
|
Date
|
Action
|
Notes
|
|---|---|---|
| 2022-01-01 | Changed | AMA guideline removed. |
| 2017-01-01 | Changed | Guidelines added. |
| 1994-01-01 | Added | First appearance in code book in 1994. |
Get instant expert-level medical coding assistance.