2025 CPT code 33768
(Active) Effective Date: N/A Surgery - Cardiovascular System Feed
Anastomosis, cavopulmonary, second superior vena cava (List separately in addition to primary procedure)
Modifiers may be applicable depending on specific circumstances (e.g., assistant surgeon, reduced services). Consult modifier guidelines for appropriate usage.
Medical necessity for this code is established by the underlying cardiac anomaly requiring surgical correction, along with documentation justifying the need for the additional cavopulmonary anastomosis to optimize blood flow and improve cardiac function.
The surgeon performs this procedure during a more complex cardiac corrective surgery. This includes dissecting the necessary vessels, creating the anastomosis, managing cardiopulmonary bypass, restarting the heart, controlling bleeding, and closing the surgical site.
In simple words: This procedure creates a new connection between a vein (left superior vena cava) and an artery (left pulmonary artery) in the heart during a heart defect repair surgery. This helps redirect blood flow to the lungs, making the heart's job easier.
During a separate cardiac anomaly correction procedure, the provider surgically creates a shunt between the left superior vena cava and the left pulmonary artery. The aim of this procedure is to completely divert the deoxygenated blood to the lungs so as to reduce the work of the heart. At the same operative session as a provider performs a cardiac anomaly corrective procedure such as a modified Fontan procedure, the provider dissects out an additional left superior vena cava vessel and nearby left pulmonary artery branch. He divides the vena cava, and occludes it where it joins the heart. He then makes an opening in the left pulmonary artery, and connects the vena cava to the pulmonary artery. He then discontinues the cardiopulmonary bypass and restarts the heart. Finally, he stops all bleeding and closes the chest wall by suturing the soft tissues in layers.
Example 1: A patient undergoing a modified Fontan procedure for tricuspid atresia requires an additional connection between the left superior vena cava and the left pulmonary artery to optimize blood flow to the lungs. Code 33768 is used in addition to the primary procedure code., A child with a complex congenital heart defect undergoes a corrective procedure that involves rerouting blood flow. The surgeon creates a second cavopulmonary anastomosis involving the left superior vena cava, necessitating the use of code 33768 along with the primary procedure code., During a complex single-ventricle repair, an additional shunt becomes necessary to improve pulmonary blood flow. The surgeon performs an anastomosis between the left superior vena cava and left pulmonary artery, reported using code 33768 as an add-on code.
Operative report detailing the primary cardiac procedure, the need for the additional anastomosis, the specific vessels involved, and the technique used. Pre- and postoperative imaging studies supporting the diagnosis and the surgical intervention.
- Revenue Code: P2F - MAJOR PROCEDURE, CARDIOVASCULAR - OTHER
- Specialties:Cardiothoracic Surgery, Pediatric Cardiology
- Place of Service:Inpatient Hospital