Summary & Overview
CPT 33020: Removal of Clot or Foreign Body from Pericardial Space
CPT code 33020 denotes surgical removal of a clot or foreign body from the pericardial space. The code captures a high-acuity, invasive cardiac procedure typically performed in an operating room or other acute inpatient setting to relieve pericardial tamponade or eliminate obstructive material. Nationally, accurate coding for this service affects clinical reporting, hospital quality measures, and appropriate payment for complex cardiac surgical care. Key payers in common reimbursement and coverage discussions include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. This publication provides a concise overview of CPT code 33020, clarifies the clinical context and typical sites of service, and summarizes what readers will learn: commonly observed billing and documentation considerations, payer coverage patterns where available, and relevant coding relationships. Data not available in the input will be identified as such in detailed sections. The content is intended for hospital administrators, coding professionals, and clinicians involved in perioperative cardiac care who need a clear reference to the clinical meaning and administrative considerations associated with CPT code 33020.
Billing Code Overview
CPT code 33020 describes a procedure in which the provider removes a clot or foreign body from the pericardial space. This service involves direct evacuation of pericardial contents to relieve tamponade or remove material that may impair cardiac function.
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Service type: Surgical procedure for pericardial clot or foreign body removal
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Typical site of service: Hospital operating room, cardiac surgery suite, or other acute inpatient setting where pericardial access and surgical support are available
Clinical & Coding Specifications
Clinical Context
A typical patient is a 58-year-old male who presents to the emergency department with acute chest pain, hypotension, and signs of cardiac tamponade after blunt chest trauma or recent percutaneous cardiac procedure. Initial evaluation includes bedside transthoracic echocardiography demonstrating a large pericardial effusion with echogenic material consistent with clot or organized hemopericardium. The cardiothoracic surgery or interventional cardiology team is consulted. After resuscitation and stabilization in the operating room or hybrid cath lab, the patient undergoes pericardial exploration under general anesthesia with incision or pericardial window creation and evacuation of clot and any foreign material from the pericardial space.
The clinical workflow includes preoperative consent and time-out, anesthesia induction, sterile preparation, pericardial exposure (subxiphoid, thoracoscopic, or median sternotomy depending on stability and etiology), manual and suction removal of clot/foreign body, inspection for bleeding source, hemostasis, possible placement of pericardial drain, and postoperative monitoring in the intensive care unit for recurrent effusion or hemodynamic instability. Documentation must describe the removal of clot or foreign body from the pericardial space and the approach, findings, estimated blood loss, and any concurrent procedures.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services |