2025 CPT code 33735

Atrial septectomy or septostomy; closed heart (Blalock-Hanlon type operation).

Diagnostic cardiac catheterization may be reported separately if performed and meets specific criteria outlined in CPT guidelines.Multiple stents placed at a single location are reported with a single code; additional stent placements at different locations are reported separately. Angioplasty at the target lesion is included, while angioplasty at a separate lesion can be reported separately.

Modifiers may be applicable. Modifier 22 (Increased Procedural Services) can be used for significantly increased complexity. Modifier 52 (Reduced Services) would be appropriate if a portion of the procedure was not performed. Other modifiers may apply based on specific circumstances.

Medical necessity must be clearly documented. The specific congenital heart defect necessitating the procedure, its impact on the patient's circulation and oxygenation, and the reason for choosing a closed-heart approach should be explained.The procedure should be justified as a bridge to definitive corrective surgery or as a palliative measure in cases where corrective surgery is not immediately feasible.

The surgeon performs the procedure after the patient is prepped and anesthetized. They access the heart through a chest incision, typically a median sternotomy. Without using cardiopulmonary bypass, they occlude parts of the atria and pulmonary veins before either removing the atrial septum or creating an opening. The procedure concludes with closing the chest incision.

In simple words: This procedure creates an opening or removes the wall between the top two chambers of the heart without using a heart-lung machine. The chest is opened, the heart is accessed, and the wall between the chambers is either removed or a hole is created to improve blood flow. This technique, called the Blalock-Hanlon, is not commonly used anymore.

This procedure involves creating an opening in the atrial septum (the wall separating the heart's right and left atria) or removing the atrial septum entirely. This is done through a closed-heart approach, meaning the patient is not placed on cardiopulmonary bypass. The surgeon opens the chest, typically via a median sternotomy, occludes portions of the atria and pulmonary veins, and then either excises the atrial septum or creates a hole in it to allow oxygenated blood flow from the left to right atrium.The chest is then closed by suturing the tissues in layers.  This procedure, known as the Blalock-Hanlon technique, is performed to alter blood flow and is no longer commonly used.

Example 1: A newborn with transposition of the great arteries and poor oxygen mixing requires improved blood circulation before undergoing corrective surgery., An infant with certain congenital heart defects needs enhanced blood oxygenation until they are stable enough for a more complex repair., A baby with inadequate mixing of oxygenated and deoxygenated blood undergoes this procedure as a temporary measure before a complete surgical correction.

Documentation should include details of the congenital heart defect, pre-operative imaging studies, operative report describing the technique (septectomy or septostomy), and post-operative status.

  • Revenue Code: P2F - Major Procedure, Cardiovascular - Other
  • Specialties:Cardiothoracic Surgery, Pediatric Cardiology
  • Place of Service:Inpatient Hospital
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