2025 CPT code 33993
(Active) Effective Date: N/A Surgery - Cardiovascular System Feed
Repositioning of percutaneous right or left heart ventricular assist device with imaging guidance at separate and distinct session from insertion.
Modifier 59 may be appended to indicate that the procedure was distinct from another procedure performed on the same day.
Medical necessity for 33993 must be supported by documentation demonstrating that the VAD repositioning was necessary to address a specific problem, such as reduced pump effectiveness, patient discomfort, or potential complications, and that the procedure was performed at a separate and distinct session from the initial insertion.
The provider uses imaging guidance, such as transesophageal echocardiography (TEE), to reposition the ventricular assist device (VAD).The VAD is a mechanical pump that helps the heart pump blood to the rest of the body. During TEE, a probe with an ultrasound transducer is inserted into the esophagus.This allows the provider to visualize the heart and adjust the percutaneous VAD and cannulas to ensure correct placement. The procedure may involve adjusting the VAD flow level and repositioning the device tip.
In simple words: The doctor adjusts the position of a heart pump (VAD) that was previously placed inside the patient's body. This adjustment is done using imaging technology to ensure the pump is in the correct place and working effectively.This procedure happens on a different occasion than when the pump was initially inserted.
The physician repositions a percutaneous right or left ventricular assist device (VAD), which was inserted in the patient during a prior procedure. The repositioning of the VAD ensures the proper placement of the cannula. This procedure is performed under radiologic or imaging guidance.
Example 1: A patient with a previously implanted percutaneous VAD experiences reduced pump effectiveness.Imaging reveals a slight displacement of the cannula. The physician performs code 33993 to reposition the VAD under imaging guidance., During a routine follow-up, a patient's percutaneous VAD is found to be partially dislodged, causing discomfort. The physician uses imaging guidance to reposition the device, billing code 33993., A patient develops complications related to the positioning of their percutaneous VAD.The physician performs a separate procedure, guided by imaging, to reposition the device for optimal function (33993).
Documentation should include the reason for repositioning, the type of imaging guidance used (e.g., TEE), the details of the repositioning procedure, and the confirmation of the final VAD position.
- Specialties:Cardiothoracic Surgery, Interventional Cardiology
- Place of Service:Inpatient Hospital, Outpatient Hospital