2025 CPT code 33545

Repair of a postinfarction ventricular septal defect, with or without myocardial resection.

Follow all applicable CPT guidelines for surgical procedures on the cardiovascular system.Appropriate documentation is crucial for accurate coding and reimbursement.

Modifiers may apply depending on the specific circumstances of the procedure. For example, modifier 51 may be used for multiple procedures, while modifier 80 might be added if an assistant surgeon is involved.

Medical necessity is established by the presence of a symptomatic postinfarction ventricular septal defect demonstrated by echocardiography, causing hemodynamic compromise (reduced cardiac output) and clinical symptoms such as shortness of breath, chest pain, or fatigue.

The surgeon performs the procedure, which typically involves median sternotomy (opening the chest), cardiac arrest, cardiopulmonary bypass (CPB), opening the ventricle, removing damaged tissue (if needed), patching the VSD, reinforcing the closure, and closing the incision. Anesthesiologist and potentially other surgical assistants are involved.

IMPORTANT For myocardial resection to repair a ventricular aneurysm, see 33542. For ventricular remodeling (VR), surgical ventricular restoration (SVR), surgical anterior ventricular endocardial restoration (SAVER), or Dor procedure, see 33548.33999 (unlisted cardiac surgery procedure) may be used in certain situations, such as partial left ventriculectomy, but may be considered investigational or experimental by some payers.

In simple words: The doctor repairs a hole in the wall between the heart's lower chambers that developed after a heart attack. This hole disrupts blood flow, and the repair restores it. Damaged heart muscle may also be removed during the surgery.

This CPT code encompasses the surgical repair of a ventricular septal defect (VSD) that occurs after a myocardial infarction (heart attack).The procedure involves patching the defect in the septum—the wall between the heart's ventricles—to restore normal blood flow. Myocardial resection, the removal of damaged heart muscle tissue, may be included if necessary.

Example 1: A 65-year-old male patient experiences a heart attack and develops a postinfarction ventricular septal defect.The surgeon performs a surgical repair using a patch, closing the defect and restoring normal blood flow., A 72-year-old female patient has a postinfarction ventricular septal defect accompanied by significant damaged heart muscle. The surgeon performs the VSD repair and also removes the damaged myocardial tissue (myocardial resection)., A 58-year-old patient post-heart attack develops a VSD and is found to have a small aneurysm in the area. During the surgical procedure to repair the VSD, the surgeon also excises the aneurysm.

Preoperative echocardiogram demonstrating the VSD. Operative report detailing the surgical procedure, including the type of patch used and any myocardial resection performed. Postoperative echocardiogram showing successful repair.Patient history and physical exam documenting the heart attack and subsequent development of the VSD.

** This code is used to report a relatively complex cardiac surgical procedure.Accurate documentation and adherence to CPT guidelines are paramount for proper coding and billing.

  • Payment Status: Active
  • Modifier TC rule: Not applicable
  • Specialties:Cardiothoracic Surgery, Cardiac Surgery
  • Place of Service:Inpatient Hospital, Ambulatory Surgical Center
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