Summary & Overview
CPT 33502: Ligation of Coronary Artery Originating from Pulmonary Artery
CPT code 33502 denotes a pediatric cardiothoracic surgical procedure to ligate a coronary artery that anomalously originates from the pulmonary artery. The operation addresses a life‑threatening congenital anomaly in which coronary-to-pulmonary arterial flow can lead to volume and pressure overload of the pulmonary circulation, progressive congestive heart failure, and failure to thrive in infants. Nationally, this code reflects a high-acuity inpatient surgical service performed by specialized pediatric cardiac surgery teams.
Key payers covered in this national overview include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find clinical context for the indication and typical inpatient surgical setting, plus guidance on common billing considerations for high‑complexity congenital cardiac procedures. The publication outlines typical service characteristics, expected sites of service, and commonly associated modifiers (listed separately), while noting where supplemental data were not provided.
This resource is intended to inform clinical administrators, coding professionals, and policy analysts about the procedural intent of CPT code 33502, payer relevance, and the operational context in which the code is used. It also signals topics readers can expect to explore further in the full publication: utilization benchmarks, payer policy summaries, and coding nuances for complex pediatric cardiac surgery.
Billing Code Overview
CPT code 33502 describes a surgical procedure in which the provider ties off a coronary artery that arises anomalously from the pulmonary artery. This congenital vascular anomaly allows high-pressure coronary blood flow into the pulmonary circulation, which the pulmonary artery cannot tolerate; surgical ligation prevents progressive congestive heart failure and corrects failure to thrive in affected infants.
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Service type: Surgical congenital cardiac procedure
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Typical site of service: Inpatient hospital, operating room (pediatric cardiothoracic surgery)
Clinical & Coding Specifications
Clinical Context
An infant is diagnosed with an anomalous coronary artery arising from the pulmonary artery (commonly ALCAPA — anomalous left coronary artery from the pulmonary artery). Typical presentation includes tachypnea, poor feeding, failure to thrive, diaphoresis with feeds, and signs of congestive heart failure. Diagnosis is confirmed by echocardiography and often cardiac catheterization or CT angiography to delineate coronary anatomy and myocardial perfusion.
The clinical workflow begins with neonatology or pediatric cardiology evaluation, stabilization of heart failure with diuretics and inotropes as needed, and urgent surgical consultation. The cardiothoracic surgical team schedules corrective surgery; in the specific corrective step described by 33502, the surgeon ties off the anomalous coronary origin at the pulmonary artery to prevent left-to-right shunting of coronary blood into the pulmonary circulation. The procedure is performed in a cardiac operating room under general anesthesia with cardiopulmonary bypass available. Postoperative care occurs in a pediatric cardiac intensive care unit with monitoring for myocardial ischemia, arrhythmia, and ventilatory/hemodynamic support. Typical inpatient stay includes post-op imaging (echocardiography) and follow-up by pediatric cardiology for long-term surveillance of ventricular function and coronary perfusion.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 |