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CPC · Question #29

A 60-year-old male has three-vessel disease and supraventricular tachycardia which has been refractory to other management. He previously had pacemaker placement and stenting of LAD coronary artery…

The correct answer is D. 33535, 33259 51, 33519-51, 33508-51. The CABG procedure involved multiple bypasses, with the use of autologous saphenous vein grafts and the left internal mammary artery, along with an extensive modified MAZE procedure. CPT® code 33535 describes a coronary artery bypass using arterial grafts, including at least…

30,000 Series CPT®: Respiratory, Cardiovascular, Hemic & Lymphatic Systems, Mediastinum, Diaphragm

Question

A 60-year-old male has three-vessel disease and supraventricular tachycardia which has been refractory to other management. He previously had pacemaker placement and stenting of LAD coronary artery stenosis, which has failed to solve the problem. He will undergo CABG with autologous saphenous vein and an extensive modified MAZE procedure to treat the tachycardia. He is brought to the cardiac OR and placed in the supine position on the OR table. He is prepped and draped, and adequate endotracheal anesthesia is assured. A median sternotomy incision is made and cardiopulmonary bypass is initiated. The endoscope is used to harvest an adequate length of saphenous vein from his left leg. This is uneventful and bleeding is easily controlled. The vein graft is prepared and cut to the appropriate lengths for anastomosis. Two bypasses are performed: one to the circumflex and another to the obtuse marginal. The left internal mammary is then freed up and it is anastomosed to the ramus, the first diagonal, and the LAD. An extensive maze procedure is then performed and the patient is weaned from bypass. At this point, the sternum is closed with wires and the skin is reapproximated with staples. The patient tolerated the procedure without difficulty and was taken to the PACU. Choose the procedure codes for this surgery.

Options

  • A33533, 33257, 33519, 33508
  • B33535, 33259, 33519, 33508
  • C33533, 33257-51, 33519-51, 33508-51
  • D33535, 33259 51, 33519-51, 33508-51

How the community answered

(32 responses)
  • A
    13% (4)
  • B
    25% (8)
  • C
    9% (3)
  • D
    53% (17)

Explanation

The CABG procedure involved multiple bypasses, with the use of autologous saphenous vein grafts and the left internal mammary artery, along with an extensive modified MAZE procedure. CPT® code 33535 describes a coronary artery bypass using arterial grafts, including at least three coronary artery bypasses. CPT® code 33259-51 is for the MAZE procedure for supraventricular tachycardia, with the -51 modifier indicating multiple procedures. CPT® code 33519-51 is for an additional vein graft, and CPT® code 33508-51 describes the endoscopic harvesting of the vein.

Topics

#CABG#MAZE procedure#arrhythmia surgery#combined cardiac procedures

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