2025 CPT code 33974

Removal of an intra-aortic balloon pump from the ascending aorta, including repair of the aorta, with or without a graft.

Follow current CPT coding guidelines for cardiac surgery procedures. Accurate documentation is crucial for appropriate reimbursement.The use of modifiers (e.g., -59 for distinct procedural service) might be appropriate in certain situations depending on the complexity of the procedure.

Modifiers may be applicable depending on the circumstances of the procedure. For example, modifier -59 might be used if the removal and repair are considered distinct procedures performed on the same day.

Medical necessity for code 33974 is established when the IABP is no longer providing hemodynamic benefit and removal is necessary for patient safety and recovery. This usually occurs after the acute phase of the patient's illness has passed and stable hemodynamic parameters are restored with other therapies. Aortic repair is medically necessary if there is damage or trauma to the aorta during insertion or removal.

The clinical responsibility lies with the cardiovascular surgeon or a qualified interventional cardiologist.This involves pre-operative assessment of the patient's condition, meticulous surgical technique during the removal and repair of the aorta, and post-operative monitoring to ensure the patient's stability and recovery.The surgeon may need to collaborate with anesthesiologists, perfusionists, and other members of the surgical team.

IMPORTANT 33970 (Insertion of IABP via femoral artery, open approach) and 33971 (Removal of IABP via femoral artery with repair) are alternative codes if the IABP was initially placed through the femoral artery.33973 (Insertion of IABP via ascending aorta) is used for initial placement through the ascending aorta.Codes 33967 and 33968 relate to percutaneous insertion and removal of IABP respectively.

In simple words: The doctor removes a device (intra-aortic balloon pump) that helps the heart pump blood.The doctor also repairs the aorta (main artery) and may use a patch if needed.

This CPT code, 33974, represents the removal of a previously implanted intra-aortic balloon pump (IABP) from the ascending aorta.The procedure includes repair of the ascending aorta, which may necessitate the use of a graft depending on the extent of damage or the surgical approach.The removal process involves reopening the sternotomy incision (if initially accessed via sternotomy), careful extraction of the IABP catheter, and meticulous repair of the aortotomy site. This might involve tying off the catheter entry point, suturing, or grafting, depending on the initial insertion technique and the condition of the aorta.The procedure is performed after the patient's hemodynamic status has stabilized.

Example 1: A patient with severe cardiogenic shock following an acute myocardial infarction requires IABP support. After stabilization, the IABP is removed via a sternotomy, and the aortotomy is repaired with sutures., A patient with an IABP in place for post-operative support after a complex cardiac surgery experiences complications. The IABP needs to be urgently removed, necessitating aortic repair with a synthetic graft due to significant aortic wall damage., A patient with an IABP placed percutaneously through the femoral artery requires removal.However, a significant hematoma forms at the femoral artery puncture site, requiring repair with sutures.

Detailed operative notes describing the surgical approach (sternotomy or other), the method of IABP removal, the extent of aortic repair (including graft details if applicable), and any complications encountered. Pre-operative and post-operative echocardiograms or other imaging studies to assess hemodynamic status. Pathology reports if tissue samples were collected during repair.

** The price for this procedure can vary based on the location, facility, and complexity of the case.Consult the relevant fee schedule for specific payment information.

  • Payment Status: Active
  • Modifier TC rule: This code does not typically involve a technical component (TC) modifier.
  • Specialties:Cardiothoracic Surgery, Cardiovascular Surgery
  • Place of Service:Inpatient Hospital, Ambulatory Surgical Center
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