2025 CPT code 33851
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Cardiovascular System Surgery Feed
Excision of coarctation of the aorta, with or without associated patent ductus arteriosus; repair using either the left subclavian artery or prosthetic material as a gusset for enlargement.
Modifiers may apply based on the circumstances of the procedure (e.g., 51 for multiple procedures, 22 for increased procedural service, 59 for distinct procedural service). Consult the CPT manual and payer-specific guidelines for appropriate modifier application.
Medical necessity for 33851 is established by the presence of a hemodynamically significant coarctation of the aorta causing symptoms such as hypertension, upper extremity hypertension, lower extremity hypotension, heart failure, or other complications.The procedure is medically necessary to improve blood flow and reduce the risk of long-term complications.
The surgeon is responsible for performing the thoracotomy, controlling blood flow using vascular clamps, excising the coarctation and any associated PDA, widening the aorta using a left subclavian artery flap or prosthetic graft, closing the incision with sutures, and placing chest tubes or drainage tubes as needed. Anesthesiologist provides anesthesia; other medical staff assist as directed.
In simple words: This code describes surgery to fix a narrowing in the aorta (the body's main artery).The surgeon removes the narrowed part and widens the artery using either a piece of another artery or a synthetic patch. This may also involve fixing an associated heart defect.
This CPT code encompasses the surgical excision of a coarctation of the aorta, addressing the narrowing of the aorta.The procedure may also include the repair of an associated patent ductus arteriosus (PDA). Repair involves widening the narrowed area of the aorta using either a section of the patient's left subclavian artery or a prosthetic material (a synthetic patch or graft) to create a gusset, effectively enlarging the aortic lumen. The surgical approach typically involves a thoracotomy (incision into the chest wall) to access the coarctation. Vascular clamps are used to control blood flow during the procedure. If a PDA is present, it is ligated (tied off) and excised (removed). The narrowed aortic section is incised (cut), and the chosen material (left subclavian artery flap or prosthetic material) is used to create the gusset and enlarge the vessel. The incision is closed with sutures, and chest tubes or drainage tubes may be placed for post-operative management.
Example 1: A 6-month-old infant presents with a significant coarctation of the aorta and a patent ductus arteriosus.Surgical repair using 33851 is indicated due to the severity of the coarctation.The surgeon performs a thoracotomy, excises the narrowed aortic segment, and repairs the PDA using ligation. The aorta is widened using a prosthetic patch., A 10-year-old child with a moderate coarctation of the aorta undergoes surgical repair using 33851.The surgeon performs a thoracotomy, excises the narrowed segment, and enlarges the aorta using a flap from the patient's left subclavian artery., An adult patient with recurrent coarctation after a previous repair presents for surgical revision using 33851. The surgeon employs a prosthetic patch to widen the recurrently narrowed section of the aorta.
Preoperative echocardiogram, cardiac catheterization (if performed), operative report detailing the surgical technique (including the material used for repair), postoperative echocardiogram, and any relevant pathology reports.Complete patient history and physical examination notes including pre and post-operative assessments.
** The choice between using a left subclavian artery flap or prosthetic material depends on several factors including the extent of the coarctation, the surgeon's preference, and the patient's overall clinical condition.Post-operative care typically involves monitoring blood pressure, monitoring for complications such as bleeding or infection, and managing pain. Regular follow-up is required to assess for the recurrence of coarctation.
- Revenue Code: P2F (MAJOR PROCEDURE, CARDIOVASCULAR - OTHER)
- Payment Status: Active
- Modifier TC rule: No TC modifier applies as this is a complete surgical procedure.
- Specialties:Cardiothoracic Surgery, Cardiovascular Surgery, Pediatric Cardiology
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center