2025 CPT code 33619
(Active) Effective Date: N/A Revision Date: N/A Surgery - Cardiovascular System Feed
Repair of single ventricle with aortic outflow obstruction and aortic arch hypoplasia (hypoplastic left heart syndrome) (e.g., Norwood procedure).
Modifiers may apply. Common modifiers used with 33619 include 22 (Increased Procedural Services), 51 (Multiple Procedures), 62 (Two Surgeons), 80 (Assistant Surgeon), and others if applicable to the specific scenario.
The Norwood procedure is medically necessary for newborns with HLHS to provide adequate blood flow to the body and lungs, which is essential for survival. Other single ventricle defects where the left side of the heart is underdeveloped may also qualify for this procedure when deemed medically necessary by the treating physician.
The surgeon performs the Norwood procedure, which involves opening the chest, creating an atrial septal defect, connecting the aorta to the pulmonary artery to create a larger aorta, creating a shunt to the lungs (like a Blalock-Taussig shunt), and managing cardiopulmonary bypass. The surgeon is responsible for all aspects of the surgical procedure, including pre-operative planning, intra-operative management, and post-operative care.
In simple words: The Norwood procedure is the first of a series of open-heart surgeries for babies born with hypoplastic left heart syndrome (HLHS), a condition where the left side of the heart is underdeveloped.This surgery creates a new main artery (aorta) and a pathway for blood to reach the lungs, allowing the right side of the heart to pump blood to both the body and the lungs.
This code describes the Norwood procedure, a complex open-heart surgery performed on newborns with hypoplastic left heart syndrome (HLHS).The procedure involves creating a new, larger aorta using part of the pulmonary artery, and creating a shunt to redirect blood flow to the lungs. This allows the right ventricle to pump blood to both the lungs and the body. The procedure also typically involves creating an atrial septal defect and closing the ductus arteriosus.
Example 1: A newborn diagnosed with HLHS within the first few days of life undergoes the Norwood procedure to allow the right ventricle to pump blood to both the body and lungs., A newborn with critical aortic stenosis and an underdeveloped left ventricle undergoes the Norwood procedure as a palliative measure., A newborn with HLHS has a Norwood procedure with a Sano modification, where the shunt is placed from the right ventricle to the pulmonary artery.
Documentation should include the diagnosis of HLHS or another qualifying single ventricle defect, operative report detailing the surgical technique (including type of shunt used), and post-operative notes documenting the patient's progress and recovery.
** The Norwood procedure is the first stage in a three-stage surgical palliation for HLHS, followed by the Glenn procedure and the Fontan procedure. The success rate and long-term outcomes of the Norwood procedure vary, and ongoing specialized care is essential for these patients.
- Revenue Code: P2F
- Payment Status: Active
- Modifier TC rule: Information not found.
- Fee Schedule: Information not found.
- Specialties:Pediatric Cardiovascular Surgery, Congenital Heart Surgery
- Place of Service:Inpatient Hospital