2025 CPT code 33370
(Active) Effective Date: N/A Surgery - Surgical Procedures on the Cardiovascular System Surgery Feed
Transcatheter placement and subsequent removal of cerebral embolic protection device(s), including arterial access, catheterization, imaging, and radiological supervision and interpretation, percutaneous.
This code is an add-on code. Modifiers are generally appended to the primary procedure code for the TAVR/TAVI.
Medical necessity for 33370 is established by the need to protect against cerebral embolization during TAVR/TAVI, especially in patients at high risk for stroke.
The physician performing the TAVR/TAVI is responsible for the placement and removal of the cerebral embolic protection device. This includes prepping the patient, obtaining arterial access, deploying and retrieving the filter, and ensuring proper closure of the access site.
In simple words: During a minimally invasive heart valve replacement, a small device is temporarily inserted into an artery to catch any blood clots or debris that might break loose and travel to the brain. This procedure, done through a small incision in the skin, involves placing and later removing this protective filter. It's done in the same setting as the valve replacement and includes imaging and monitoring to ensure proper placement and removal.
This add-on code describes the percutaneous placement and removal of one or more cerebral embolic protection devices during a transcatheter aortic valve replacement (TAVR/TAVI) procedure. It includes arterial access, catheterization, imaging guidance, radiological supervision and interpretation.The procedure aims to prevent clots and debris dislodged during the TAVR/TAVI from reaching the brain.It involves making a small incision, placing a sheath and guide catheter, deploying the filter(s), and then removing them along with any debris after the TAVR/TAVI.The code also encompasses closure of the arteriotomy.Extensive repair or replacement of an artery is not included and may be reported separately.
Example 1: A patient undergoing TAVR via femoral artery access has a cerebral embolic protection device placed prior to valve deployment and removed after the valve is successfully implanted., A patient with a history of stroke undergoes TAVR, requiring the placement of multiple cerebral embolic protection filters to minimize the risk of further embolic events., During a TAVR procedure, a cerebral embolic protection device is placed. Following the TAVR, the device is removed, and due to complications at the access site, extensive arterial repair is required and reported separately.
Documentation should include details of the TAVR/TAVI procedure, the type and placement of the cerebral embolic protection device(s), imaging guidance used, and any complications encountered during placement or removal.
** Code 33370 includes all imaging guidance, radiological supervision, and interpretation associated with the placement and removal of the cerebral embolic protection device.Separate reporting for these services is not allowed.
- Modifier TC rule: Not applicable, as 33370 is an add-on code and does not have a separate technical component.
- Specialties:Interventional Cardiology, Cardiothoracic Surgery
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center