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2025 CPT code 33018

Percutaneous pericardial drainage with indwelling catheter placement, including imaging guidance, for patients birth through 5 years of age or any age with congenital cardiac anomaly.

Refer to current CPT coding guidelines and CMS regulations for proper use and limitations.

Modifiers may be applicable in certain situations. Refer to iFrameAI to verify this information.

Medical necessity must be established for this procedure. It is typically justified by the presence of a clinically significant pericardial effusion or cardiac tamponade causing symptoms or posing a risk to the patient's health. In the case of congenital cardiac anomalies, the procedure may be necessary for diagnosis or management related to the anomaly.

The physician preps and anesthetizes the patient, selects a puncture site, and inserts a needle attached to a syringe or suction device into the pericardial space using imaging guidance. Fluid is aspirated, and a catheter is inserted and left in place for further drainage.

IMPORTANT:Do not report 33017, 33018 in conjunction with 75989, 76942, 77002, 77012, 77021. Do not report 33016, 33017, 33018 in conjunction with 93303-93325 when echocardiography is performed solely for pericardiocentesis guidance. For CT-guided pericardial drainage, use 33019. For patients 6 years and older without congenital cardiac anomaly, use 33017.

In simple words: This procedure drains fluid from around the heart and places a small tube to keep the fluid from building back up. It's used for newborns, infants, and children up to 5 years old, or for anyone with a heart defect present from birth.The doctor uses imaging to guide a needle into the area around the heart and drain the fluid.

This code describes a percutaneous procedure for draining fluid from the pericardium (the sac surrounding the heart) and inserting an indwelling catheter for continued drainage.It is used for patients from birth through 5 years of age or for patients of any age with a congenital cardiac anomaly. The procedure includes fluoroscopic and/or ultrasound guidance.The catheter is left in place after the procedure is complete for continued drainage.

Example 1: A 2-year-old child presents with pericardial effusion due to an infection.Percutaneous pericardial drainage with catheter placement is performed under ultrasound guidance., A 40-year-old patient with a congenital heart defect develops cardiac tamponade. Percutaneous drainage with catheter placement is performed under fluoroscopic guidance., A newborn with a congenital cardiac anomaly requires pericardial drainage for diagnostic purposes.The procedure is performed with ultrasound guidance and an indwelling catheter is left in place for possible further drainage.

Documentation should include the indication for the procedure (e.g., pericardial effusion, cardiac tamponade), the patient's age and congenital cardiac anomaly status (if applicable), the type of imaging guidance used, the amount and character of fluid drained, and confirmation that the catheter was left in place.

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