CPT code 33660 is used for procedures involving the repair of heart defects, helping healthcare providers categorize and document medical services.
CPT code 33660 is a medical billing code used to describe the surgical procedure for the repair of heart defects, specifically addressing congenital heart anomalies. This code is utilized by healthcare providers to document and bill for the surgical correction of defects such as atrial septal defects, ventricular septal defects, or other structural abnormalities within the heart. The procedure typically involves open-heart surgery, where the surgeon repairs the defect to improve heart function and patient outcomes. Proper use of this code ensures accurate billing and reimbursement for the complex and specialized care provided during these surgical interventions.
For CPT code 33660, which pertains to the repair of heart defects, 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 the complexity of the heart defect or unexpected complications during the surgery.
2. Modifier 51 - Multiple Procedures: If multiple procedures are performed during the same surgical session, this modifier indicates that more than one procedure was conducted. It helps in the correct billing and reimbursement for each procedure.
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 particularly useful when procedures are not typically reported together but are appropriate under the circumstances.
4. Modifier 62 - Two Surgeons: When two surgeons work together as primary surgeons performing distinct parts of a procedure, this modifier is used. It is applicable if the repair of heart defects requires the expertise of two surgeons.
5. Modifier 66 - Surgical Team: This modifier is used when a complex procedure requires the skills of several physicians, often across different specialties, working together as a 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: If the patient needs to return to the operating room for a related procedure during the postoperative period, this modifier is applicable.
7. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: This modifier is used when a procedure is performed during the postoperative period of another procedure, but it is unrelated to the original procedure.
8. Modifier 80 - Assistant Surgeon: If an assistant surgeon is required to help with the procedure, this modifier is used to indicate their involvement.
9. Modifier 81 - Minimum Assistant Surgeon: This is used when an assistant surgeon is required on a minimal basis during the procedure.
10. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available): This modifier is used when an assistant surgeon is necessary because a qualified resident surgeon is not available.
These modifiers help in accurately capturing the specifics of the procedure performed, ensuring proper billing and reimbursement, and reflecting the complexity and resources involved in the surgical repair of heart defects.
CPT code 33660 is subject to reimbursement by Medicare, but its eligibility for payment depends on several factors, including its inclusion in the Medicare Physician Fee Schedule (MPFS) and the specific guidelines set forth by the Medicare Administrative Contractor (MAC) for the region in which the service is provided.
The MPFS outlines the payment rates for services covered under Medicare Part B, and it is essential to verify whether CPT code 33660 is listed and the associated reimbursement rate.
Additionally, MACs, which are private organizations contracted by Medicare to process claims, may have specific local coverage determinations (LCDs) that affect the reimbursement of this code.
Therefore, healthcare providers should consult the MPFS and their respective MAC's policies to confirm the reimbursement status of CPT code 33660.
Discover the power of MD Clarity's RevFind software to ensure you're receiving the full reimbursement you deserve. With the ability to read your contracts and detect underpayments down to the CPT code level, including CPT code 33660, RevFind provides unparalleled accuracy and insight. Schedule a demo today to see how RevFind can help you identify discrepancies by individual payer and optimize your revenue cycle management.
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
