CPT® Code 33904

Add-On Code

Percutaneous pulmonary artery revascularization by stent placement, each additional vessel or separate lesion, normal or abnormal connections (List separately in addition to code for primary procedure)

The CPT® Code 33904 refers to the procedure of percutaneous pulmonary artery revascularization by stent placement, specifically for each additional vessel or separate lesion. This procedure is indicated for patients with stenotic lesions in the pulmonary artery that have not responded adequately to balloon angioplasty. The use of endovascular stents provides a more rigid structure to support the affected vessel, thereby improving blood flow and reducing the risk of further complications. The procedure is performed under general anesthesia and utilizes fluoroscopic guidance, which allows for real-time imaging during the intervention. It is typically conducted in conjunction with a right and/or left heart cardiac catheterization, particularly for congenital defects. The vascular access for this procedure is usually obtained through a large vein, although the specific approach may vary based on the patient's unique anatomy. Prior to the procedure, local anesthesia, such as lidocaine, is administered to the access site to minimize discomfort. The procedure involves puncturing the vein, placing a guidewire and introducer sheath, and advancing a catheter to the target area. Diagnostic angiograms are performed to assess the stenotic lesion and surrounding vessels, which aids in selecting the appropriate size stent and balloon for the intervention. The stent placement process involves several critical steps, including the exchange of catheters and guidewires, positioning the stent across the lesion, and deploying the stent using a delivery balloon. Post-deployment, further assessments are conducted to ensure optimal stent placement and function. This code is specifically used to report each additional stent placed, whether through normal or abnormal connections, and is listed separately in addition to the primary procedure codes for initial stent placements.