2025 CPT code 33418
(Active) Effective Date: N/A Surgery - Surgical Procedures on the Cardiovascular System Feed
Transcatheter mitral valve repair, percutaneous approach, including transseptal puncture when performed; initial prosthesis.
Modifiers such as 22 (Increased Procedural Services), 51 (Multiple Procedures), 59 (Distinct Procedural Service), and others may be applicable depending on the specific circumstances of the procedure.
Medical necessity must be established by documenting the severity of the mitral valve dysfunction and the symptoms it's causing.This may involve echocardiography, cardiac catheterization, and other diagnostic tests showing significant mitral regurgitation or stenosis impacting the patient's quality of life or posing a risk to their health.The chosen approach (transcatheter) should be justified based on the patient's overall health and suitability for open surgery.
The physician is responsible for prepping and anesthetizing the patient, inserting the catheter, navigating it to the heart, performing the transseptal puncture if necessary, deploying the mitral valve repair prosthesis, managing any bleeding complications, and closing the incision site.
In simple words: This procedure repairs a leaky mitral valve in the heart without open-heart surgery. A thin tube is inserted through a vein in the groin and guided to the heart.A small puncture may be made in the wall between the heart's upper chambers. Then, a small device is placed to fix the valve, improving blood flow.
This code describes a procedure where the physician repairs a mitral valve using a catheter inserted through the skin.This approach includes a transseptal puncture if performed, and placement of an initial prosthesis. The procedure involves inserting a catheter through a vein, typically in the groin, advancing it to the heart, and accessing the mitral valve.A transseptal puncture may be necessary to cross from the right atrium to the left atrium. The repair involves placing a device, such as a clip, to improve valve function. This code includes all associated steps like accessing the vein, positioning the device, and deploying it.
Example 1: A patient with severe mitral regurgitation is not a candidate for open-heart surgery. Transcatheter mitral valve repair is performed percutaneously, including a transseptal puncture., A patient with symptomatic mitral stenosis undergoes transcatheter mitral valve repair via a percutaneous approach. Transseptal puncture is not required in this case., A patient with a failing mitral valve prosthesis undergoes a transcatheter mitral valve repair with placement of a new prosthetic device.
Documentation should include details of the procedure, including the approach used, the type of prosthesis placed, any complications encountered, and the pre- and post-procedure assessment of the mitral valve function.Any associated procedures, like transseptal puncture, should also be documented. Medical necessity for the procedure should be clearly justified.
- Revenue Code: P2F: MAJOR PROCEDURE, CARDIOVASCULAR - OTHER
- Payment Status: Active
- Specialties:Interventional Cardiology, Cardiothoracic Surgery
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center