CPT® Code 33025

The procedure described by CPT® Code 33025 involves the creation of a pericardial window or the partial resection of the pericardium, primarily aimed at facilitating drainage. This surgical intervention is performed using an open approach, which can include techniques such as the subxiphoid approach, median sternotomy, or anterior thoracotomy. The subxiphoid approach is often preferred due to its less invasive nature and the ease of access it provides to the pericardial space. During the procedure, the linea alba, which is the fibrous structure that runs down the midline of the abdomen, is divided just below the xiphoid process, and this process may involve excising the xiphoid process itself if necessary. Once the peritoneum is retracted, the pericardium, the fibrous sac surrounding the heart, is exposed and incised to allow for the aspiration of any fluid present, which is subsequently sent to the laboratory for culture analysis. The creation of a pericardial window or the partial resection of the pericardial sac is achieved by resecting a section of approximately 3-4 cm of the pericardial sac. Following this, the pericardium is carefully examined, and a sponge may be introduced to break up any loculated fluid collections. If required, a second window can be created using the same technique. To ensure effective drainage of the pericardial space, a chest tube is placed into the pericardial window, allowing for continuous removal of fluid and preventing potential complications associated with fluid accumulation around the heart.