CPT code 33611 is used for procedures involving the repair of a double ventricle, a complex heart surgery to improve cardiac function.
CPT code 33611 is used to describe the surgical procedure for repairing a double ventricle in the heart. This code is specifically assigned to operations that address congenital heart defects where both ventricles of the heart require surgical intervention to restore normal function. The procedure typically involves intricate surgical techniques to correct structural abnormalities, ensuring that the heart can effectively pump blood throughout the body. This code is crucial for accurate billing and documentation, allowing healthcare providers to communicate the complexity and specifics of the cardiac repair performed.
For CPT code 33611, which pertains to the repair of a double ventricle, the following modifiers may be applicable:
1. Modifier 22 - Increased Procedural Services: This modifier is used when the work required to perform the procedure is substantially greater than typically required. This could be due to factors such as increased complexity or time.
2. Modifier 51 - Multiple Procedures: If multiple procedures are performed during the same surgical session, this modifier indicates that the procedure is one of several performed.
3. Modifier 59 - Distinct Procedural Service: This modifier is used to indicate that a procedure or service was distinct or independent from other services performed on the same day. It is used to avoid bundling of services that are typically considered part of a single procedure.
4. Modifier 62 - Two Surgeons: When two surgeons work together as primary surgeons performing distinct parts of a procedure, this modifier is used to indicate the collaborative effort.
5. Modifier 66 - Surgical Team: This modifier is applicable when a complex procedure requires the services of a surgical team.
6. Modifier 78 - Unplanned Return to the Operating/Procedure Room by the Same Physician Following Initial Procedure for a Related Procedure During the Postoperative Period: This modifier is used when a patient requires a return to the operating room for a related procedure during the postoperative period.
7. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: This modifier is used when a procedure is performed by the same physician during the postoperative period of another procedure, but the procedure is unrelated to the original.
These modifiers help provide additional information about the circumstances under which the procedure was performed, ensuring accurate billing and reimbursement. Always verify with the latest coding guidelines and payer-specific requirements, as these can vary.
CPT code 33611 is subject to reimbursement by Medicare, but its coverage and payment are determined by several factors, including the Medicare Physician Fee Schedule (MPFS) and the policies set forth by the Medicare Administrative Contractor (MAC) in your specific region.
The MPFS provides a comprehensive list of fees that Medicare uses to reimburse physicians and other healthcare providers for their services. However, the actual reimbursement can vary based on local coverage determinations (LCDs) made by the MACs, which are responsible for interpreting national policies and setting guidelines for their respective jurisdictions.
Therefore, it is crucial for healthcare providers to consult the MPFS and their regional MAC to confirm the reimbursement status and any specific requirements or limitations associated with CPT code 33611.
Discover how MD Clarity's RevFind software can enhance your revenue cycle management by accurately reading your contracts and identifying underpayments down to the CPT code level, including specific codes like 33611. Schedule a demo today to see how RevFind can help you maximize reimbursements and streamline your financial operations.
Get paid in full by bringing clarity to your revenue cycle
Subscribe to the
Healthcare Clarified newsletter
Get the latest insights on RCM and healthcare policy in your inbox
