2025 CPT code 33975

Insertion of a ventricular assist device; extracorporeal, single ventricle.

Adhere to all applicable CPT coding guidelines, including those pertaining to surgical procedures and cardiac interventions. Pay special attention to unbundling rules to ensure accurate reimbursement.

Modifiers may be applicable in certain scenarios, such as modifier 59 (distinct procedural service) if additional procedures are performed on the same day. Consult current CPT guidelines and payer-specific rules for applicable modifiers.

Medical necessity for code 33975 is established when a patient has end-stage heart failure unresponsive to medical management and requires temporary circulatory support to stabilize the patient while awaiting a heart transplant or other definitive therapy.The procedure must be medically necessary and appropriate to the patient's clinical condition.

The surgeon's responsibilities include pre-operative planning, performing the median sternotomy (or reopening a previous one), creating the abdominal pocket and subcutaneous tunnel, initiating and managing cardiopulmonary bypass (CPB), precise placement of inflow and outflow cannulae, connecting to the VAD pump, ensuring proper device function, gradually weaning the patient off CPB, placing the device in its pocket, and closing the incision. Post-operative monitoring and management of the VAD are also crucial.

IMPORTANT 33976 (Insertion of ventricular assist device; extracorporeal, biventricular), 33979 (Insertion of ventricular assist device; percutaneous, single or biventricular), 33990 (Insertion of ventricular assist device; percutaneous, single ventricle), 33991 (Insertion of ventricular assist device; percutaneous, biventricular), 33995 (Insertion of ventricular assist device; percutaneous, single or biventricular)

In simple words: The doctor inserts a device into the patient's heart to help it pump blood. This is done for people with weak or failing hearts.The device is placed outside the body and only helps one side of the heart.

This CPT code 33975 describes the insertion of an extracorporeal ventricular assist device (VAD) to support a single ventricle.The procedure involves creating or reopening a median sternotomy, extending the incision to the abdomen to create a pocket and tunnel for the device. Cardiopulmonary bypass (CPB) is initiated. An incision is made in the ventricle, and inflow and outflow cannulas are attached, connecting to the VAD pump.The device is then placed in the prepared pocket, and the incision is closed.The VAD provides temporary circulatory support until the ventricle recovers or a heart transplant/artificial heart is performed.

Example 1: A 65-year-old male patient with severe heart failure and significantly reduced left ventricular ejection fraction is experiencing life-threatening decompensation.After thorough evaluation, including echocardiography and cardiac catheterization, the decision is made to implant an extracorporeal left ventricular assist device (LVAD) as a bridge to transplantation.Code 33975 is used to bill this procedure., A 72-year-old female patient with end-stage heart failure presents with severe cardiogenic shock.Due to the urgency and patient instability, an emergency extracorporeal VAD implantation is performed.In this scenario, code 33975 is reported., An 80-year-old patient with severe right ventricular failure secondary to pulmonary hypertension requires temporary circulatory support.A right ventricular assist device (RVAD) is implanted using an extracorporeal approach.This would still be billed under code 33975 unless the device is clearly biventricular in nature, and in that case 33976 would be used.

* Pre-operative evaluation including patient history, physical examination, echocardiogram, cardiac catheterization results, and other relevant imaging studies.* Intra-operative documentation detailing the surgical approach (median sternotomy), creation of the abdominal pocket and tunnel, initiation and management of cardiopulmonary bypass, cannula placement, device implantation, and closure of incisions.* Post-operative notes documenting the device function, hemodynamic parameters, and patient's response to the VAD.* Detailed information regarding the specific type of VAD utilized (manufacturer, model, specifications).

** Thorough documentation is critical for appropriate reimbursement.Ensure that the documentation clearly supports the medical necessity of the procedure and accurately reflects the services provided.It is advisable to refer to the most current AMA CPT manual and payer-specific guidelines for comprehensive coding instructions.

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