2025 CPT code 33496
(Active) Effective Date: N/A Surgical Procedures on the Cardiovascular System - Cardiovascular System Surgery Feed
Repair of non-structural prosthetic valve dysfunction with cardiopulmonary bypass (separate procedure).
Modifiers may apply, such as 22 for increased procedural services or 51 for multiple procedures.
Medical necessity must be established by documenting the patient's symptoms, diagnostic testing results (e.g., echocardiogram), and the clinical rationale for surgical intervention.
The physician's responsibilities include prepping and anesthetizing the patient, making the incision, initiating and managing cardiopulmonary bypass, performing the valve repair, closing the incisions, and managing post-operative care.
In simple words: This procedure is done to fix a heart valve that isn't working properly. The surgeon uses a heart-lung machine to keep the blood flowing while they repair the valve. They open the chest, access the heart, and fix the valve by removing any blockages or by stitching it up.
With the patient on cardiopulmonary bypass, the provider repairs a dysfunctional or leaking prosthetic valve that is not working properly due to overgrowth of vascular structures or exudate. The procedure involves making an incision into the area of the previous sternotomy, initiating cardiopulmonary bypass, visualizing the valve by making an incision in the aorta, performing the necessary repair (removing clots, thrombus, or exudate, or inserting new sutures), closing the aortic incision, weaning the patient off bypass, and closing the chest incision.
Example 1: A patient with a prosthetic aortic valve presents with symptoms of valve dysfunction due to pannus overgrowth. The surgeon performs a repair of the non-structural prosthetic valve dysfunction with cardiopulmonary bypass (33496)., A patient with a prosthetic mitral valve experiences valve leakage due to thrombus formation. The surgeon performs a repair of the non-structural prosthetic valve dysfunction using cardiopulmonary bypass (33496)., A patient who underwent prosthetic valve replacement several months prior experiences valve dysfunction due to exudate buildup. The surgeon performs a reoperation, requiring code 33530 along with 33496 for the repair of the non-structural prosthetic valve dysfunction with cardiopulmonary bypass.
Documentation should include the reason for the procedure, details of the valve dysfunction, operative report detailing the repair performed, and confirmation of the use of cardiopulmonary bypass.
- Revenue Code: P2F - Major Procedure, Cardiovascular - Other
- Payment Status: Inpatient Only (IPO)
- Specialties:Cardiothoracic Surgery
- Place of Service:Inpatient Hospital