© Copyright 2025 American Medical Association. All rights reserved.
An extracorporeal ventricular assist device (VAD) is a mechanical device designed to support the heart's function by assisting in the pumping of blood. This procedure involves the insertion of a VAD into one or both of the heart's ventricles, which are the lower chambers responsible for pumping blood to the lungs and the rest of the body. The VAD consists of a mechanical pump, a control system, and an energy supply, all of which work together to facilitate blood circulation. Unlike implantable devices, an extracorporeal VAD operates externally, with pumps that are situated outside the body and connected to the heart via cannulas. VADs are primarily utilized in patients who are awaiting a heart transplant, providing crucial support during this waiting period. They are also employed to prolong the lives of patients suffering from severe heart failure, offering a temporary solution to maintain adequate blood flow. Additionally, VADs can be used post-operatively following heart surgery to aid in the recovery of one or both ventricles, ensuring that the heart can regain its function effectively. The procedure typically involves a median sternotomy, which is a surgical incision made along the sternum to access the heart. Cardiopulmonary bypass is initiated to maintain blood circulation and oxygenation during the surgery, allowing the surgical team to work on the heart safely. The insertion of the VAD is a complex process that requires careful manipulation and suturing to ensure proper placement and function of the device.
© Copyright 2025 Coding Ahead. All rights reserved.
The insertion of an extracorporeal ventricular assist device (VAD) is indicated for several critical conditions related to heart function. These include:
The procedure for the insertion of a biventricular assist device involves several critical steps to ensure proper placement and function of the device:
Post-procedure care following the insertion of a biventricular assist device includes monitoring the patient's vital signs and hemodynamic status closely. The patient will typically remain in an intensive care unit (ICU) setting for continuous observation. It is essential to assess the function of the VAD regularly, ensuring that blood flow is adequate and that there are no complications such as bleeding or infection at the cannula and graft sites. The healthcare team will also monitor for any signs of heart recovery or the need for further interventions. Patients may require additional support, including medications to manage heart function and anticoagulation therapy to prevent blood clots. Rehabilitation and gradual mobilization will be initiated as the patient's condition stabilizes, with a focus on optimizing recovery and preparing for potential heart transplant if applicable.
| Short Descr | IMPLANT VENTRICULAR DEVICE | Medium Descr | INSJ VENTRIC ASSIST DEV XTRCORP BIVENTRICULAR | Long Descr | Insertion of ventricular assist device; extracorporeal, biventricular | Status Code | Active Code | Global Days | XXX - Global Concept Does Not Apply | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 2 - 150% payment adjustment 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) | 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 |
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) | 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 | GC | This service has been performed in part by a resident under the direction of a teaching physician | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
|
Date
|
Action
|
Notes
|
|---|---|---|
| 2002-01-01 | Changed | Code description changed. |
| 1994-01-01 | Added | First appearance in code book in 1994. |
Get instant expert-level medical coding assistance.