CPT 33019 Pericardial Drainage Reimbursement | OpenPayer

Summary & Overview

CPT 33019: Percutaneous Pericardial Drainage with Indwelling Catheter

CPT code 33019 covers percutaneous pericardial drainage with placement of an indwelling catheter, a procedure used to remove fluid from the pericardial space and allow ongoing drainage. This procedure matters nationally because pericardial effusion and cardiac tamponade are time-sensitive conditions with significant morbidity and mortality; timely, coded drainage enables appropriate clinical management, facility resource allocation, and payer adjudication. Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.

Readers will find a concise explanation of the clinical service represented by CPT code 33019, typical sites of service, and why accurate coding is important for clinical documentation and billing workflows. The publication provides benchmarks where available, notes on coding context and clinical indications, and highlights policy considerations that affect coverage and utilization review at national payers. Data not available in the input is noted where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 33019pericardial drainagepericardial effusioninterventional radiologycardiology procedureshospital servicesprocedure codingpercutaneous drainageclinical documentation

Billing Code Overview

CPT code 33019 describes a percutaneous procedure in which a clinician inserts a needle through the chest wall to drain fluid from the pericardial space and places an indwelling catheter for continued drainage. Service type: percutaneous pericardial drainage with catheter placement. Typical site of service: inpatient or outpatient hospital settings, including interventional radiology suites, cardiac catheterization labs, or operating rooms, depending on clinical need and imaging guidance availability.

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A typical patient is an adult presenting with progressive dyspnea, chest discomfort, hypotension, or signs of cardiac tamponade after cancer, infection, uremia, or post-procedural complication. Diagnostic imaging (portable chest x-ray and transthoracic echocardiography or CT) confirms a clinically significant pericardial effusion with hemodynamic compromise or persistent symptomatic effusion. The interventional workflow includes informed consent, coagulation assessment, IV access, and monitoring in a monitored procedure suite or interventional radiology/operating room. Under sterile conditions and local anesthesia with conscious sedation or general anesthesia as indicated, a percutaneous subxiphoid or transthoracic needle is advanced through the chest wall into the pericardial space under ultrasound or computed tomography guidance. Fluid is aspirated and a catheter is placed and secured for continued drainage. Post-procedure care includes serial vital signs, echocardiography as needed, catheter output monitoring, and catheter removal when drainage has decreased and effusion resolved. Typical site of service is an interventional radiology suite, operating room, or procedure room in an inpatient or outpatient hospital setting. Service type: image-guided percutaneous pericardial drainage with indwelling catheter placement (33019).

Coding Specifications

Modifier	Description	When to Use
`11`	Normally scheduled service or procedure

CPT 33018: Percutaneous Pericardial Drainage with Indwelling Catheter

CPT-33020-PERICARDIAL-CLOT-FOREIGN-BODY-REMOVAL

CPT 33020: Removal of Clot or Foreign Body from Pericardial Space

CPT-33025-PERICARDIAL-WINDOW-PERICARDIOTOMY-DRAINAGE

CPT 33025: Pericardial Window (Pericardiotomy)

CPT-33050-PERICARDIAL-TUMOR-CYST-EXCISION

CPT 33050: Pericardial Tumor or Cyst Excision

CPT-33030-PERICARDIAL-TISSUE-REMOVAL-WITHOUT-CPB

CPT 33030: Removal of Damaged Pericardial Tissue Without Cardiopulmonary Bypass

CPT-33016-PERICARDIOCENTESIS-PERCUTANEOUS-DRAINAGE

CPT 33016: Percutaneous Pericardiocentesis with Imaging Guidance

CPT-33031-PERICARDIECTOMY-CARDIOPULMONARY-BYPASS

CPT 33031: Pericardiectomy With Cardiopulmonary Bypass

CPT-33017-PERCUTANEOUS-PERICARDIAL-DRAINAGE-CATHETER

CPT 33017: Percutaneous Pericardial Drainage with Indwelling Catheter

Taxonomy Code	Specialty	Notes
2080P0001X	Interventional Cardiology	Performs percutaneous pericardial drainage in cardiac settings.
2084P0800X	Interventional Radiology	Common provider for image-guided pericardial drain placement.
207RC0000X	Cardiothoracic Surgery	Performs surgical pericardial drainage or pericardiectomy when indicated.
207L00000X	Thoracic Surgery	Provides operative management for complex pericardial disease.
207RC0000X	Cardiac Surgery	Serves as consultant for hemodynamically unstable patients.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`I31.3`	Pericardial effusion (noninflammatory)	Direct indication for pericardial drainage when effusion is hemodynamically significant.
`I31.4`	Effusion of pericardium, unspecified	Used when documentation specifies pericardial effusion without further specification.
`I31.9`	Disease of pericardium, unspecified	Used for pericardial disease leading to effusion or tamponade requiring drainage.
`I40.9`	Acute myocarditis, unspecified	Myocardial inflammation may be associated with pericardial effusion requiring drainage.
`R57.0`	Cardiogenic shock	Hemodynamic compromise from large effusion/tamponade may present with shock requiring emergent drainage.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`33020`	Pericardiocentesis, including imaging guidance when performed, without indwelling catheter	Alternative to `33019` when only needle aspiration is performed without catheter placement.
`76937`	Ultrasound guidance for needle placement (e.g., vascular access, pericardial, pleural)	Often used to guide needle/catheter placement for pericardial drainage.
`77012`	CT guidance for biopsy, aspiration and/or catheter placement (initial needle or catheter placement)	Used when computed tomography guidance is employed during `33019` (CT guidance is included in `33019` when performed; report only if payer requires separate CT guidance coding policy).
`99152`	Moderate sedation services provided by the same physician performing or supervising the procedure (initial 15 minutes)	Used when moderate sedation is provided by the proceduralist during the drainage procedure.
`51798`	Placement of catheter for urethral or urinary drainage (example of catheter placement coding principles)	Not directly related clinically but conceptually analogous for documentation of indwelling catheter placement principles.

OpenPayer