2025 CPT code 33477
Transcatheter pulmonary valve implantation (TPVI), including percutaneous access, placing the access sheath, advancing the repair device delivery system into position, repositioning the device as needed, and deploying the device(s); including pre-, intra-, and post-procedural angiography, radiological supervision and interpretation, intraprocedural contrast injections, and imaging guidance necessary to complete the pulmonary valve procedure
Modifiers may be applicable in certain situations, such as modifier 59 for distinct diagnostic procedures. Refer to CPT guidelines for specific modifier application rules.
Medical necessity for TPVI is established by demonstrating the presence of a dysfunctional pulmonary valve, conduit stenosis, or other condition requiring valve replacement, and that the patient is a suitable candidate for a transcatheter approach.
The physician is responsible for the entire TPVI procedure, from patient preparation and anesthesia to percutaneous access, device deployment, and post-procedural care. This includes managing any complications and ensuring proper device function.
In simple words: This procedure involves implanting a pulmonary valve through a catheter. The doctor inserts a thin tube into a blood vessel, guides it to the heart, and places a new valve without open-heart surgery.This code includes all the steps involved, from accessing the blood vessel to checking the valve's placement with imaging.
This code encompasses the entire transcatheter pulmonary valve implantation procedure. It includes percutaneous access, sheath placement, device delivery system advancement and positioning, device deployment, and necessary angiography, radiological supervision, interpretation, contrast injections, and imaging guidance.It also includes percutaneous balloon angioplasty of the conduit/treatment zone, valvuloplasty of the pulmonary valve conduit, and stent deployment within the pulmonary conduit or existing bioprosthetic pulmonary valve, when performed.
Example 1: A pediatric patient with a congenital pulmonary valve defect undergoes TPVI to replace the faulty valve., An adult patient with a failing bioprosthetic pulmonary valve undergoes TPVI to avoid open-heart surgery., A patient with a narrowed pulmonary conduit receives a stent during TPVI to ensure proper valve function.
Documentation should include details of the patient's condition, the pre-procedural evaluation, the procedure itself (including access site, device used, and any complications), and post-procedural assessment of valve function. Imaging findings and hemodynamic measurements should also be documented.
** Code 33477 includes all cardiac catheterizations, contrast injections, fluoroscopic supervision, interpretation, and imaging guidance performed to complete the pulmonary valve procedure.
- Specialties:Interventional cardiology, cardiothoracic surgery, pediatric cardiology
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center