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2025 CPT code 33741

Transcatheter atrial septostomy (TAS) creates effective atrial blood flow for congenital heart defects, using various methods (e.g., balloon, blade).

Follow current CPT coding guidelines and any payer-specific requirements.Consult the CPT manual for detailed guidance on appropriate use and reporting.

Modifier 22 (increased procedural services), 51 (multiple procedures), 52 (reduced services), 76 (repeat procedure by same physician) or 77 (repeat procedure by another physician) may apply under specific circumstances.Consult current CPT coding guidelines for modifier usage rules.Modifier 63 is explicitly excluded from use with this code.

The procedure is medically necessary when a patient has a congenital heart defect causing significant hemodynamic compromise and improved atrial blood flow is required to stabilize the patient and/or improve oxygenation.Supporting documentation such as echocardiography and hemodynamic data should demonstrate the clinical need.

The physician or qualified healthcare provider performs the procedure, including vascular access, catheter insertion and advancement, creation of the atrial communication, and post-procedure care.

IMPORTANT:33745 (for intracardiac shunt creation by stent placement); 93462 (for transseptal puncture);Diagnostic cardiac catheterization codes (93451-93461, 93593-93597) may be separately reported under specific circumstances.

In simple words: This procedure uses a thin tube (catheter) inserted through a blood vessel to create an opening in the wall between the heart's upper chambers (atria). This improves blood flow for babies born with heart defects.Imaging guidance is used.

Transcatheter atrial septostomy (TAS) is a percutaneous procedure performed to improve atrial blood flow in patients with congenital heart defects.It involves percutaneous access, sheath placement, advancement of a transcatheter delivery system, and creation of an atrial communication using a method such as balloon septostomy, Rashkind's procedure, or blade septostomy.The procedure includes ultrasound guidance for vascular access and fluoroscopic guidance for the intervention. Diagnostic cardiac catheterization is not typically included and should be separately reported if performed.

Example 1: A neonate with a severe atrial septal defect (ASD) requires improved atrial blood flow to improve oxygenation.A transcatheter atrial septostomy using the Rashkind technique is performed., An infant with transposition of the great arteries undergoes a balloon atrial septostomy as a palliative measure to improve mixing of oxygenated and deoxygenated blood., A child with hypoplastic left heart syndrome requires a transcatheter atrial septostomy to enhance systemic blood flow before subsequent stages of the surgical palliation.

Complete medical history, including indication for the procedure, imaging studies (e.g., echocardiogram) demonstrating the need for intervention, procedural report with details of the technique used, type and size of catheter(s) utilized, any complications encountered, and post-procedure hemodynamic assessment.Documentation supporting medical necessity.

** This procedure is often performed in critically ill infants and children.Careful attention should be given to proper documentation to ensure appropriate billing and reimbursement.

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