Cardiovascular system code changes 2021

CPT 2021 introduced five new codes and four revised codes in the cardiovascular system. Three new shunting procedure codes for congenital cardiac anomalies and two new ventricular assist device codes are added. The current codes for VAD are revised to incorporate the service for left heart.

Still not read about the respiratory system changes? Read here!

New shunting procedure codes: 33741, 33745, 33746

Transcatheter atrial septostomy (TAS):

Code 33741 is added newly to report the transcatheter atrial septostomy (TAS) procedure for congenital anomalies. The procedure involves the percutaneous creation of improved atrial blood flow by any methods such as balloon/blade. The procedure also includes imaging guidance when performed.

Currently we use CPT codes 92992 and 92993 from medicine section to report for the septostomy procedures. CPT 92992 is used to report septostomy procedure by balloon method (eg, Rashkind type) and CPT 92993 is used to report septostomy procedure by blade method (Park septostomy). From 2021, these two codes are deleted and a new code 33741 is used report the septostomy procedure incorporating both the methods in its code description.

33741 Transcatheter atrial septostomy (TAS) for congenital cardiac anomalies to create effective atrial flow, including all imaging guidance by the proceduralist, when performed, any method (eg, Rashkind, Sang-Park, balloon, cutting balloon, blade)

Transcatheter intracardiac shunt (TIS):

Code 33745 is added newly to report intracardiac shunt creation using a stent for effective intracardiac flow. The procedure includes stent placement, target zone angioplasty, diagnostic cardiac catheterization and imaging guidance when performed.

Code 33746 is used to describe each additional intracardiac shunt creation by stent placement at a separate location during the same session as the primary intervention (33745).

33745 Transcatheter intracardiac shunt (TIS) creation by stent placement for congenital cardiac anomalies to establish effective intracardiac flow, all imaging guidance by the proceduralist when performed, left and right heart diagnostic cardiac catherization for congenital cardiac anomalies, and target zone angioplasty, when performed (eg, atrial septum, Fontan fenestration, right ventricular outflow tract, Mustard/Senning/Warden baffles); initial intracardiac shunt

33746each additional intracardiac shunt location (Use 33746 in conjunction with 33745)

Ventricular assist device VAD:

Currently the codes 33990, 33991, 33992 and 33993 are used to report ventricular assist devices based on the access type such as arterial or venous. The code description lacks information about the right or left heart in all these codes. Therefore the existing codes are revised to include the service for left heart and new codes are added to include the service for right heart.

Revised codes:

Codes 33990 and 33991 are revised to specify the procedure that involves the left heart and code 33992 is revised to report the removal of VAD from the left heart.

Code 33993 is revised to report the repositioning of right or left VAD at separate and distinct session from insertion.

33990: Insertion of ventricular assist device, percutaneous including radiological supervision and interpretation; left heart, arterial access only

33991: Insertion of ventricular assist device, percutaneous including radiological supervision and interpretation; left heart, both arterial and venous access, with transseptal puncture

33992: Removal of percutaneous left heart ventricular assist device, arterial or arterial and venous cannula(s), separate and distinct session from insertion

33993: Repositioning of percutaneous right or left heart ventricular assist device, with imaging guidance, at separate and distinct session from insertion

New codes:

Two new codes are added to report the ventricular assist device codes that involve the right heart.

New code 33995 is used to report the insertion of ventricular assist device in the right heart and new code 33997 is used to report the removal of ventricular assist device from the right heart at a separate and distinct session from the VAD insertion.

33995: Insertion of ventricular assist device, percutaneous, including radiological supervision and interpretation; right heart, venous access only

33997: Removal of percutaneous right heart ventricular assist device, venous cannula, separate and distinct session from insertion

Happy learning! Happy coding!

Resources:

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