2025 CPT code 33363
(Active) Effective Date: N/A Surgery - Surgical Procedures on the Cardiovascular System Feed
Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve, using an open axillary artery approach.
Modifier 62 (Two Surgeons) is required when two surgeons perform distinct parts of the TAVR procedure. Other modifiers may be applicable in specific situations, such as 59 (Distinct Procedural Service) for separately reportable diagnostic coronary angiography performed during the same session.
Medical necessity must be justified by documentation demonstrating severe symptomatic aortic stenosis in patients who are high-risk or unsuitable for traditional surgical aortic valve replacement.
Two physicians are typically required for this procedure. One physician focuses on the surgical aspects of accessing the axillary artery and deploying the valve, while the other specializes in imaging guidance and monitoring.
In simple words: The doctor replaces a faulty heart valve with an artificial one through a small cut near the shoulder. This procedure is less invasive than open-heart surgery. A small cut is made near the shoulder, a new valve is inserted through a tube, and then guided to the heart.The damaged valve is replaced with the new one, and the incision is closed.This procedure is also known as TAVR or TAVI.
This code describes a transcatheter aortic valve replacement (TAVR/TAVI) procedure where an open incision is made in the axillary artery (located in the shoulder area) to access the circulatory system. A prosthetic valve is then advanced to the heart using a catheter, and placed at the site of the damaged aortic valve, under imaging guidance. This code includes percutaneous access, sheath placement, valvuloplasty, valve delivery and positioning, temporary pacemaker insertion, and arteriotomy closure.
Example 1: A 78-year-old patient with severe aortic stenosis is considered high-risk for traditional open-heart surgery. TAVR via the axillary artery approach is chosen due to suitable vascular access., A patient has previously undergone a sternotomy and has significant scarring, making a transaortic approach difficult. An open axillary artery approach for TAVR is chosen., A patient with peripheral artery disease has unsuitable femoral arteries, thus an axillary artery approach for TAVR is performed.
Documentation should include details of the patient's aortic stenosis, pre-operative assessment for TAVR, operative report outlining the axillary artery approach, valve deployment details, and post-operative outcomes. Any complications or additional procedures (e.g., pacemaker insertion) should also be documented.
** As of December 1st, 2024, this information is current. However, coding guidelines and reimbursement policies can change, so it's essential to verify the latest information with payers and coding resources.For the most up-to-date information and further details, consult the iFrameAI product.
- RVU: 25.47 (as of 2024)
- Specialties:Cardiothoracic Surgery, Interventional Cardiology, Radiology
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center