CPT code 33897 is used for a procedure involving the repair of a narrowed or blocked blood vessel in the chest area.
CPT code 33897 is used to describe a percutaneous transluminal angioplasty procedure specifically for the native or recurrent coarctation of the aorta. This procedure involves using a catheter to widen a narrowed section of the aorta, which is the major artery carrying blood from the heart to the rest of the body. The term "percutaneous" indicates that the procedure is minimally invasive, typically performed through a small incision in the skin. "Transluminal" refers to the technique of navigating through the lumen, or the inside space of the blood vessel, to reach the area of narrowing. This code is essential for accurately documenting and billing for this specific cardiovascular intervention.
For CPT code 33897, which involves percutaneous transluminal angioplasty for native or recurrent coarctation, the following modifiers may be applicable:
1. Modifier 26 - Professional Component: This modifier is used when the professional component of a service is being billed separately from the technical component. It is applicable if the physician is only providing the interpretation of the procedure.
2. Modifier 52 - Reduced Services: This modifier is used when a service or procedure is partially reduced or eliminated at the physician's discretion. It may apply if the full angioplasty procedure was not completed.
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 may be necessary if multiple procedures are performed that are not typically reported together.
4. Modifier 76 - Repeat Procedure by Same Physician: This modifier is used when the same procedure is repeated by the same physician. It may be applicable if the angioplasty needs to be performed again within a short period.
5. Modifier 77 - Repeat Procedure by Another Physician: This modifier is used when the same procedure is repeated by a different physician. It may be relevant if another physician performs the angioplasty shortly after the initial procedure.
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 if the patient needs to return to the procedure 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 an unrelated procedure is performed by the same physician during the postoperative period of the initial procedure.
8. Modifier 80 - Assistant Surgeon: This modifier is used when an assistant surgeon is required for the procedure. It may be applicable if the complexity of the angioplasty necessitates an assistant.
9. Modifier 81 - Minimum Assistant Surgeon: This modifier is used when a minimum assistant surgeon is required for the procedure.
10. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available): This modifier is used when an assistant surgeon is required because a qualified resident surgeon is not available.
These modifiers help provide additional information about the circumstances of the procedure and ensure accurate billing and reimbursement. Always verify with the latest coding guidelines and payer-specific requirements, as these can vary.
The CPT code 33897 is subject to reimbursement by Medicare, but its coverage and payment are determined by several factors, including its inclusion in the Medicare Physician Fee Schedule (MPFS) and the policies set by the Medicare Administrative Contractor (MAC) for the specific region.
The MPFS provides a comprehensive list of services covered by Medicare and assigns relative value units (RVUs) that influence reimbursement rates. However, the final decision on whether CPT code 33897 is reimbursed can vary based on local coverage determinations (LCDs) made by the MACs, which consider regional medical necessity and other criteria.
Therefore, healthcare providers should consult the MPFS and their respective MAC's guidelines to confirm the reimbursement status of CPT code 33897.
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 specific codes like 33897, 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
