Summary & Overview
CPT 33945: Heart Transplant Surgery, With or Without Cardiectomy
CPT code 33945 represents the surgical procedure for heart transplantation, with or without removal of the recipient's heart. This code is central to the management of patients with advanced heart failure and other severe cardiac conditions, marking a pivotal point in cardiothoracic surgical care. Heart transplants are performed in inpatient hospital settings and require coordination among multidisciplinary teams.
The publication covers key national payers, including Aetna, Blue Cross Blue Shield, Cigna Health, Medicare, and UnitedHealthcare. Readers will gain insight into payer coverage, clinical indications, and the procedural context for heart transplantation. The summary includes benchmarks for utilization, policy updates, and an overview of related codes and modifiers relevant to billing and reimbursement. Additionally, the article provides context on associated diagnoses and taxonomies, helping stakeholders understand the clinical and administrative landscape for this high-complexity procedure.
This resource is designed for healthcare professionals, policy analysts, and revenue cycle teams seeking a comprehensive overview of CPT code 33945 and its implications in the current healthcare environment.
CPT Code Overview
CPT code 33945 describes a heart transplant procedure, which may include removal of the recipient's heart (cardiectomy) as part of the surgery. This code is used in the context of cardiothoracic surgery and is typically performed in an inpatient hospital setting (Place of Service 21). Heart transplantation is a critical intervention for patients with end-stage heart disease, offering improved survival and quality of life when other treatments have failed.
Clinical & Coding Specifications
Clinical Context
A typical patient scenario involves an adult patient with end-stage heart failure who has not responded to medical management and is evaluated for heart transplantation. The patient may have diagnoses such as chronic systolic (congestive) heart failure, cardiomyopathy, or atherosclerotic heart disease. After multidisciplinary assessment and listing for transplant, the patient is admitted to the inpatient hospital (Place of Service 21) when a suitable donor heart becomes available. The surgical team, including a cardiothoracic surgeon and possibly an assistant surgeon, performs the heart transplant procedure, which may include removal of the recipient's heart (cardiectomy). Postoperative care is provided in the hospital setting, with ongoing monitoring for graft function and complications.
Coding Specifications
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Modifiers:
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80: Assistant Surgeon. Used when an additional qualified surgeon assists in the procedure. - Modifier
82: Assistant Surgeon (when qualified resident surgeon not available). Used when a qualified resident surgeon is unavailable and an assistant surgeon is required.
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Provider Taxonomies:
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