Need help choosing the right code?
Ask CasePilot about procedures, modifiers, bundling, and coding guidance.
Try CasePilot© Copyright 2026 American Medical Association. All rights reserved.
The procedure described by CPT® Code 33722 involves the surgical closure of a congenital aortico-left ventricular tunnel (ALVT), which is a rare cardiac defect. In this condition, there is an abnormal connection, or tunnel, that allows blood to flow directly from the left ventricle to the aorta, bypassing the aortic valve. This anomaly typically originates from the right aortic sinus, although it can also arise from the left aortic sinus. The surgical approach to repair this defect usually requires access to the heart through a median sternotomy or thoracotomy, which involves making an incision in the chest to reach the heart. During the procedure, cardiopulmonary bypass is established to take over the function of the heart and lungs, allowing the surgeon to operate on a still and bloodless field. The aorta is cross-clamped to stop blood flow, and cardioplegic arrest is initiated to protect the heart muscle during the repair. A horizontal incision is made in the aorta to access the tunnel, where the surgeon inspects the aortic wall to locate the tunnel's orifice. The opening at the aorta is then closed using sutures or a patch graft, effectively obliterating the tunnel. After the closure, the incision in the aorta is sutured, the aortic clamps are removed, and the patient is gradually weaned off the cardiopulmonary bypass. Finally, chest tubes may be placed to drain any excess fluid, and the chest incision is closed to complete the procedure.
© Copyright 2026 Coding Ahead. All rights reserved.
The closure of aortico-left ventricular tunnel (ALVT) is indicated for patients presenting with the following conditions:
The procedure for the closure of aortico-left ventricular tunnel involves several critical steps:
Post-procedure care for patients who have undergone closure of aortico-left ventricular tunnel includes monitoring for any complications related to the surgery, such as bleeding or infection. Patients are typically observed in a recovery area before being transferred to a regular hospital room. The expected recovery period may vary, but patients will generally require time to heal from the surgical incision and to allow the heart to adjust to the corrected blood flow. Follow-up appointments will be necessary to assess the success of the procedure and to monitor the patient's overall cardiac function.
| Short Descr | REPAIR OF HEART DEFECT | Medium Descr | CLOSURE AORTICO-LEFT VENTRICULAR TUNNEL | Long Descr | Closure of aortico-left ventricular tunnel | Status Code | Active Code | Global Days | 090 - Major Surgery | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 2 - Payment restriction for assistants at surgery does not apply to this procedure... | Co-Surgeons (62) | 1 - Co-surgeons could be paid, though supporting documentation is required... | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Inpatient Procedures, not paid under OPPS | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P2F - Major procedure, cardiovascular-Other | MUE | Not applicable/unspecified. | CCS Clinical Classification | 49 - Other OR heart procedures |
|
Date
|
Action
|
Notes
|
|---|---|---|
| 2021-12-31 | Deleted | Code deleted |
| 1994-01-01 | Added | First appearance in code book in 1994. |
Get instant expert-level medical coding assistance.