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2025 CPT code 33622

Reconstruction of complex cardiac anomaly (e.g., single ventricle or hypoplastic left heart) with palliation, including cavopulmonary anastomosis and pulmonary band removal (e.g., Norwood, bidirectional Glenn).

Refer to the official CPT manual for the most up-to-date coding guidelines.Proper documentation is crucial for accurate coding of this complex procedure.

Modifiers may apply depending on the specifics of the procedure. Consult the CPT manual and payer guidelines for appropriate modifier usage.

Medical necessity for code 33622 is established by the presence of a complex congenital cardiac anomaly necessitating surgical intervention.The severity of the anomaly and the need for palliation or reconstruction to improve hemodynamics must be documented.Justification should align with established guidelines and clinical practice standards.

Cardiac surgeon performs the procedure, including incision, cardiopulmonary bypass (CPB), atrial septectomy, ductus division, pulmonary artery closure, aortic enlargement, conduit placement (cavo-pulmonary anastomosis), pulmonary artery assessment and repair (possibly including patch graft or end-to-end anastomosis), and wound closure.Pre-operative and post-operative care are also the responsibility of the surgeon and team.

IMPORTANT:Do not report 33622 with 33619, 33767, 33822, 33840, 33845, 33851, 33853, 33917. For bilateral, bidirectional Glenn, use 33622 with 33768.

In simple words: This surgery fixes a serious heart problem present from birth, where one ventricle is underdeveloped.The surgeon creates a new pathway for blood flow, and removes any blockages to improve the heart's function. This might be one of several surgeries needed to correct the heart defect.

This code represents a complex surgical procedure to reconstruct a single ventricle or other intricate cardiac anomaly, often performed in stages.The procedure involves palliation of a single ventricle with aortic outflow obstruction and aortic arch hypoplasia. A cavopulmonary anastomosis is created, and right and left pulmonary bands are removed. This may be part of a staged approach, such as a hybrid approach (stage 2 Norwood, bidirectional Glenn, or pulmonary artery debanding).The procedure aims to improve blood flow and prevent complications like congestive heart failure and pulmonary hypertension.It often involves cardiopulmonary bypass (CPB).

Example 1: A newborn infant is diagnosed with hypoplastic left heart syndrome (HLHS).The Norwood procedure (stage 1) is performed, which includes the creation of a cavopulmonary connection, using code 33622., A child with a single ventricle undergoes a bidirectional Glenn procedure as part of a staged surgical approach to correct the congenital heart defect. Code 33622 is used to report this stage of the correction., An infant with a complex cardiac anomaly requiring a hybrid approach undergoes a staged repair involving a cavopulmonary anastomosis and pulmonary artery banding.Code 33622 reflects the surgical component of this complex repair.

* Preoperative echocardiogram and cardiac catheterization reports.* Operative report detailing all procedures performed, including specifics on the cavopulmonary anastomosis, pulmonary artery repair/banding, and any other components of the procedure.* Intraoperative data, including cardiopulmonary bypass (CPB) time and details.* Postoperative echocardiogram report.* Pathology reports (if applicable).* Complete anesthesia record.

** This procedure is highly complex and requires expert surgical skill. Accurate coding depends on comprehensive documentation of all components performed.

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