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2025 CPT code 33853

Repair of hypoplastic or interrupted aortic arch using autogenous or prosthetic material; with cardiopulmonary bypass.

Selective vascular catheterizations should be coded to include introduction and all lesser-order selective catheterizations used in the approach. Additional second and/or third-order arterial catheterizations within the same family of arteries supplied by a single first-order artery should be expressed by 36218 or 36248. Additional first-order or higher catheterizations in vascular families supplied by a first-order vessel different from a previously selected and coded family should be separately coded.

Modifiers may be applicable to this code to indicate specific circumstances, such as increased procedural services (modifier 22), multiple procedures (modifier 51), or the presence of an assistant surgeon (modifier 80).

Medical necessity is established by the presence of a diagnosed hypoplastic or interrupted aortic arch causing significant impairment of blood flow. The medical record should clearly document the symptoms, diagnostic findings, and the rationale for surgical intervention.

The surgeon is responsible for performing the repair of the hypoplastic or interrupted aortic arch. This includes preoperative planning, intraoperative execution of the procedure, and postoperative care.

IMPORTANT:For repair of hypoplastic left heart syndrome (e.g., Norwood type), via excision of coarctation of aorta, use 33619. For interrupted aortic arch repair without cardiopulmonary bypass, see 33852.

In simple words: The surgeon repairs a birth defect or tear in the aorta, the main artery from the heart, using either the patient's own tissue or an artificial material. A heart-lung machine is used during the surgery.The surgeon opens the chest, usually through the breastbone, to reach the aorta. The heart-lung machine takes over the heart and lungs’ function, allowing the surgeon to stop the heart briefly. The surgeon then fixes the affected area of the aorta and closes the incision.

The provider repairs an incompletely developed or disrupted aortic arch using either the patient's own tissue or prosthetic material. This procedure is performed with cardiopulmonary bypass.After the patient is prepped and anesthetized, the provider accesses the aortic arch through an incision in the chest, often a sternotomy. Cardiopulmonary bypass is initiated, and a cardioplegic solution is administered to temporarily stop the heart. The surgeon then incises the aortic arch at the point of hypoplasia or disruption and repairs it, connecting the two parts of the arch. The incision is then closed with sutures.

Example 1: A newborn is diagnosed with an interrupted aortic arch and requires surgical intervention to restore blood flow., A child with hypoplastic aortic arch experiences symptoms such as shortness of breath and requires surgery to widen the narrowed section of the aorta., An adult with a previously undiagnosed hypoplastic aortic arch develops complications and needs surgical repair.

Documentation should include operative reports detailing the surgical technique, type of graft used (autogenous or prosthetic), the use of cardiopulmonary bypass, and any intraoperative complications. Preoperative imaging studies and diagnostic reports confirming the diagnosis of hypoplastic or interrupted aortic arch are essential.

** This code represents a complex surgical procedure requiring specialized expertise and resources. The use of cardiopulmonary bypass adds to the complexity and risk associated with this procedure.

  • Place of Service:Inpatient Hospital
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