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The procedure described by CPT® Code 33737 refers to an atrial septectomy or septostomy performed through an open heart technique with inflow occlusion. This surgical intervention is primarily aimed at improving oxygen saturation in patients who have transposition anomalies of the great vessels, a condition where the major arteries are incorrectly connected to the heart. The procedure is categorized as palliative, meaning it is intended to relieve symptoms rather than cure the underlying condition. During the operation, the heart is accessed through a median sternotomy, which involves making an incision along the sternum to provide direct access to the heart. Inflow occlusion is a critical component of this procedure, as it temporarily interrupts venous blood flow to the heart by occluding the superior and inferior vena cava. This allows the heart to be emptied of blood, facilitating a clearer surgical field for the excision of the atrial septum. The atrial septum is a wall that separates the right and left atria of the heart, and its removal is essential in cases where a thick septum may impede proper blood flow. The careful execution of this procedure is vital to avoid damage to surrounding structures, such as the atrioventricular node, which is crucial for maintaining the heart's electrical conduction system.
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The atrial septectomy or septostomy procedure, as described by CPT® Code 33737, is indicated for patients with specific cardiac conditions that necessitate improved oxygen saturation. The primary indications include:
The procedure for CPT® Code 33737 involves several critical steps to ensure successful atrial septectomy or septostomy with inflow occlusion:
After the completion of the atrial septectomy or septostomy with inflow occlusion, patients typically require close monitoring in a postoperative setting. The placement of chest tubes is essential to manage any potential fluid accumulation in the thoracic cavity. Recovery may involve observation for any complications related to the surgery, such as bleeding or infection. The expected recovery period can vary based on the individual patient's condition and response to the procedure. Follow-up care will be necessary to assess the effectiveness of the surgery in improving oxygen saturation and overall cardiac function.
| Short Descr | REVISION OF HEART CHAMBER | Medium Descr | ATRIAL SEPTECT/SEPTOST OPN HRT W/INFL OCCLUSION | Long Descr | Atrial septectomy or septostomy; open heart, with inflow occlusion | 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 |
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| 2024-12-31 | Deleted | Code Deleted. |
| 2021-01-01 | Note | AMA Guidelines removed. |
| Pre-1990 | Added | Code added. |
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