2025 CPT code 33322
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Cardiovascular System Cardiovascular System Feed
Suture repair of the aorta or great vessels using cardiopulmonary bypass.
Modifiers may be applicable depending on the circumstances.For example, modifier 51 (multiple procedures) may be applied if multiple vessel repairs are performed during the same operative session. Modifier 22 (increased procedural services) could be used to report a significantly more extensive procedure than usual.
Medical necessity for this procedure is established by the presence of a significant injury or pathology of the aorta or other great vessels that requires surgical repair.The severity of the condition necessitates the use of CPB for safe and effective repair.
The surgeon is responsible for the entire procedure, including pre-operative preparation, incision, vascular access for CPB, repair of the great vessel(s), weaning from CPB, closure of incisions, placement of drains if necessary, wound closure, and application of sterile dressing.Anesthesiologists and perfusionists (for CPB) play essential supporting roles.
In simple words: The doctor repairs damaged large blood vessels near the heart using stitches. A heart-lung machine keeps the blood flowing and the body supplied with oxygen while the repair is done.
This procedure involves the surgical repair of the aorta or other great vessels of the heart using sutures. Cardiopulmonary bypass (CPB) is utilized to temporarily take over the function of the heart and lungs, providing a still operative field.The surgeon makes an incision (e.g., sternotomy or thoracotomy) to access the affected vessel(s), clamps the vessel, performs the suture repair, and then weans the patient off CPB.Incidental incisions related to CPB are closed, drainage is established, the wound is closed, and a sterile dressing is applied.A chest tube may be left in place.
Example 1: Scenario 1: A patient sustains a penetrating chest wound that damages the aorta.The surgeon performs an emergency sternotomy, initiates CPB, repairs the aortic tear using sutures, weans the patient from CPB, and closes the chest., Scenario 2: A patient with a dissecting aortic aneurysm undergoes elective surgery. The surgeon performs a median sternotomy, initiates CPB, repairs the aneurysm using sutures, weans the patient off CPB, and closes the chest., Scenario 3: A patient requires repair of a traumatic injury to the pulmonary artery. The surgeon performs a right thoracotomy, establishes CPB, repairs the pulmonary artery tear, weans from CPB, and closes the incision.
Operative report detailing the approach (sternotomy or thoracotomy), vessel(s) repaired, use of CPB, suture material, length of CPB time, intraoperative complications, and postoperative course.Preoperative imaging (e.g., CT scan, echocardiogram) demonstrating the need for the procedure.Anesthesia record documenting the type of anesthesia used.Perfusionist report detailing the details of the CPB.
** The specific vessels repaired should be clearly documented in the operative report.The use of CPB is a crucial component of this procedure and should be explicitly stated.Consider any potential complications, such as bleeding, infection, and neurological issues, in the postoperative period.
- Payment Status: Active
- Modifier TC rule: Not applicable.
- Specialties:Cardiothoracic Surgery, Vascular Surgery
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center