Health Information Management

Tip: Note new codes for ventricular assist devices

APCs Insider, March 1, 2013

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Codes for reporting the insertion of a ventricular assist device (VAD) are not new. However, the existing codes (33975-33983) report the insertion, removal, or replacement of VAD using extracorporeal or implantable intracorporeal approaches. For 2013, the AMA added CPT® codes to report the insertion, removal, or repositioning of a VAD percutaneously.

In a percutaneous VAD insertion procedure, a physician punctures the femoral vein, then inserts a catheter and threads it into the left atrium of the heart. The catheter carries oxygenated blood via the femoral artery, circumventing the left ventricle and reducing the intensity of work for this dysfunctional part of the heart.
 
Physicians can now safely perform it in a cardiac catheterization laboratory. The procedure requires moderate (conscious) sedation, which is included in these new codes.
 
These new codes are relatively straightforward:
  • 33990, insertion of ventricular assist device, percutaneous including radiological supervision and interpretation; arterial access only
  • 33991, insertion of ventricular assist device, percutaneous including radiological supervision and interpretation; both arterial and venous access, with transseptal puncture
  • 33992, removal of percutaneous ventricular assist device at separate and distinct session from insertion
  • 33993, repositioning of percutaneous ventricular assist device with imaging guidance at separate and distinct session from insertion
 
The tip is adapted from “New codes for cardiology procedures added to manual” in the February Briefings on APCs.



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