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2025 CPT code 33767

Creation of a shunt from the superior vena cava to the pulmonary artery to direct blood flow to both lungs (bidirectional Glenn procedure).

Follow CPT coding guidelines for proper reporting of the Glenn procedure, including any additional procedures performed during the same session. Pay attention to guidelines regarding diagnostic catheterization, angiography, and stent placement, which may or may not be reported separately.

Modifiers may be applicable in certain situations (e.g., increased procedural services, assistant surgeon). Refer to current CPT modifier guidelines.

Medical necessity is established by demonstrating that the patient has a single ventricle defect requiring staged surgical palliation. Documentation should support the clinical indication, the chosen surgical approach, and the expected benefits of the procedure.

The cardiothoracic surgeon performs the procedure, including opening the chest, placing the patient on cardiopulmonary bypass, disconnecting and reconnecting the blood vessels, and closing the incision. They also manage pre- and post-operative care.

IMPORTANT:Related codes include 33750 (shunt from subclavian artery to pulmonary artery), 33755 (shunt from ascending aorta to pulmonary artery), 33762 (shunt from descending aorta to pulmonary artery), 33764 (central shunt with prosthetic graft), and 33766 (shunt from superior vena cava to pulmonary artery for flow to one lung).

In simple words: This operation helps babies with certain heart problems where one side isn't working properly. It redirects blood from the upper body directly to the lungs to get oxygen, making it easier for the heart to pump blood to the rest of the body. This is usually the second surgery in a series of three.

This procedure involves creating a surgical connection between the superior vena cava and the pulmonary artery, allowing deoxygenated blood from the upper body to flow directly into the lungs for oxygenation. This procedure is typically performed as a second stage in a three-part surgical treatment for certain congenital heart defects, like hypoplastic left heart syndrome (HLHS), where one ventricle is underdeveloped. The Glenn procedure reduces the workload on the single functioning ventricle and improves oxygen saturation in the blood. It involves disconnecting the superior vena cava from the heart and attaching it to the pulmonary artery. If a previous shunt (like from a Norwood procedure) exists, it's removed. The procedure requires open-heart surgery, cardiopulmonary bypass, and meticulous surgical technique.

Example 1: A 6-month-old infant with HLHS undergoes the Glenn procedure as the second stage of surgical palliation., A child with tricuspid atresia undergoes a bidirectional Glenn shunt to improve oxygenation before a Fontan procedure., A baby with double outlet right ventricle requires a Glenn procedure to balance blood flow and reduce strain on the single ventricle.

Documentation should include operative reports detailing the surgical technique, pre- and post-operative diagnoses, and any complications. Imaging studies (e.g., echocardiograms, cardiac catheterizations) demonstrating the need for the procedure should also be included.

** As of December 1st, 2024, this information reflects the current understanding of CPT code 33767. Coding guidelines and medical practices are subject to change.

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