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The procedure described by CPT® Code 33978 involves the removal of a biventricular extracorporeal ventricular assist device (VAD). This device is utilized to support heart function in patients with severe heart failure. The term "extracorporeal" indicates that the device operates outside the body, assisting both the left and right ventricles of the heart. During the procedure, the physician reopens the previous sternal incision to access the chest cavity. The patient is carefully weaned from the VAD to assess whether the heart is functioning adequately on its own. If the left VAD is being removed, the aortic outflow graft is divided, and the site is closed with sutures. Similarly, if the right VAD is being removed, the pulmonary artery inflow graft is divided, and that site is also closed. The inflow cannulas from both ventricles are removed, and the respective sites are closed with purse-string sutures to ensure proper healing. After the removal, the surgical team inspects the suture sites for hemostasis, ensuring there is no excessive bleeding. Additionally, ventricular function is evaluated using transesophageal echocardiography to confirm the heart's performance post-removal. Pacing wires and chest tubes may be placed as necessary before the chest is finally closed. This procedure is critical for patients transitioning from mechanical support back to native heart function.
© Copyright 2025 Coding Ahead. All rights reserved.
The procedure described by CPT® Code 33978 is indicated for patients who have been supported by a biventricular extracorporeal ventricular assist device (VAD) and are undergoing removal of the device. The specific indications for this procedure include:
The procedure for the removal of a biventricular VAD involves several critical steps, which are detailed as follows:
Post-procedure care following the removal of a biventricular VAD includes monitoring the patient for any signs of complications, such as bleeding or infection. The patient's heart function will continue to be assessed to ensure that the heart is performing adequately without mechanical support. Additionally, the placement of pacing wires may require monitoring to ensure proper cardiac rhythm. Chest tubes, if placed, will be monitored for drainage and removed when appropriate. The recovery process will involve close observation in a critical care setting until the patient is stable and can be transitioned to a regular recovery unit.
| Short Descr | REMOVE VENTRICULAR DEVICE | Medium Descr | REMOVAL VENTR ASSIST DEVICE XTRCORP BIVENTR | Long Descr | Removal 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). | 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. | 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 | GC | This service has been performed in part by a resident under the direction of a teaching physician |
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Notes
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| 2002-01-01 | Changed | Code description changed. |
| 1994-01-01 | Added | First appearance in code book in 1994. |
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