2025 CPT code 33991
(Active) Effective Date: N/A Surgery - Surgical Procedures on the Cardiovascular System Feed
Percutaneous insertion of a ventricular assist device (VAD) into the left heart, utilizing both arterial and venous access with transseptal puncture, including radiological supervision and interpretation.
Modifiers may be applicable in specific circumstances, such as if the procedure is significantly more complex than usual (modifier 22).
Medical necessity must be established by documenting the patient's clinical condition requiring circulatory support, the severity of heart failure, and the expected benefit of the procedure. The appropriateness of a percutaneous approach over a traditional open-heart surgery must also be justified.
The physician preps and anesthetizes the patient, makes incisions to access the vascular system, inserts a catheter and the VAD under radiological guidance, performs the transseptal puncture, ensures proper VAD placement and function, and closes the access sites. The physician is also responsible for the post-operative care.
In simple words: A small mechanical pump, called a VAD, is inserted into the left side of your heart through small incisions in your skin and blood vessels. This procedure uses X-ray guidance and involves puncturing the wall between the heart chambers. The VAD helps pump blood from your heart to the rest of your body.
This code describes a percutaneous procedure where a ventricular assist device (VAD) is inserted into the patient's left heart. The procedure involves accessing the heart through both arterial and venous routes, and a transseptal puncture is performed to create a passage between the heart chambers. This code includes radiological supervision and interpretation.
Example 1: A patient with end-stage heart failure awaiting a heart transplant requires circulatory support. A percutaneous VAD is inserted into the left heart to assist in pumping blood to the rest of the body., A patient experiencing cardiogenic shock following a heart attack has severely reduced heart function. A percutaneous left heart VAD is inserted to stabilize the patient's hemodynamics and provide temporary support until the heart recovers., A patient undergoing high-risk cardiac surgery requires additional circulatory support during the procedure. A percutaneous VAD is inserted into the left heart to maintain adequate blood flow during the operation.
Documentation should include details about the patient's condition necessitating the VAD, the type of VAD inserted, the access routes used, confirmation of transseptal puncture, radiological images, intraoperative and post-operative notes, and any complications encountered.
- Payment Status: Active
- Specialties:Cardiothoracic Surgery, Interventional Cardiology
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center