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2025 CPT code 33690

Banding of pulmonary artery. This procedure involves placing a band around the pulmonary artery to restrict blood flow, often used as a staged procedure for complex congenital cardiac anomalies.

Do not report modifier 63 in conjunction with 33690.

Modifiers such as 22 (Increased Procedural Services) may be applicable in certain circumstances (e.g., unusually complex or time-consuming procedure).

Medical necessity is established by the presence of a congenital heart defect, such as a VSD, that requires staged surgical correction. Pulmonary hypertension and other complications related to the heart defect further support the medical necessity of pulmonary artery banding.

The surgeon is responsible for performing the procedure, including prepping the patient, making the incision, placing the band, ensuring hemostasis, and closing the incision. They also manage the patient's post-operative care.

IMPORTANT:For right and left pulmonary artery banding in a single ventricle (e.g., hybrid approach stage 1), use 33620.

In simple words: This procedure helps to control blood flow to the lungs in babies and children with certain heart defects. The surgeon places a small band around the main artery to the lungs, which helps to balance the blood flow within the heart and lungs. This procedure is often the first step in a series of operations to fix complex heart problems.

Placement of a band around the pulmonary artery to reduce pulmonary blood flow.This is often performed as a part of a staged procedure to correct complex congenital cardiac anomalies.The procedure involves making an incision in the chest, typically a left anterior thoracotomy, to expose the main pulmonary artery and aorta. The surgeon then places a band, often made of umbilical tape, around the mid-portion of the main pulmonary trunk, securing it with sutures and pledgets and adjusting its circumference with hemoclips.The incision is then closed.

Example 1: A newborn is diagnosed with a large ventricular septal defect (VSD) and pulmonary hypertension. To manage the pulmonary hypertension before definitive repair of the VSD, a pulmonary artery band is placed., An infant has multiple complex congenital heart defects requiring a staged approach to surgical correction. As part of the initial stage, a pulmonary artery band is placed., A child with a single ventricle physiology undergoes a hybrid stage 1 procedure involving the placement of bilateral pulmonary artery bands.

Documentation should include operative report detailing the procedure, including the size and placement of the band, the indication for the procedure (e.g. VSD), and any associated congenital heart defects. Pre-operative imaging studies, such as echocardiograms and cardiac catheterizations, should also be documented. Post-operative care and any complications should also be noted.

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