Summary & Overview
CPT 33506: Coronary Artery Reimplantation, Pulmonary to Aorta
CPT code 33506 represents surgical reimplantation of an anomalous coronary artery from the pulmonary artery to the aorta, typically performed in infants with congenital coronary anomalies to restore coronary blood flow and prevent heart failure. This high-acuity, open cardiac procedure is clinically significant because timely correction can be lifesaving and prevents progressive ventricular dysfunction and congestive heart failure. Nationally, the code is used to classify complex pediatric cardiac surgery encounters and drives inpatient surgical billing, resource allocation, and outcomes tracking.
Key payers referenced in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context, typical sites of service, and the service type represented by CPT code 33506. The publication also covers how the code maps to inpatient surgical workflows, common billing modifiers used with complex cardiac surgery claims, and what benchmarks and policy updates affect coverage and reimbursement for high-complexity pediatric cardiac procedures. The content is intended to inform billing managers, coding professionals, hospital administrators, and clinicians about the clinical intent and billing classification of this procedure, and to provide context for further operational or policy analysis.
Data not available in the input: Associated taxonomies, ICD-10 diagnoses, related codes, and service line details.
Billing Code Overview
CPT code 33506 describes surgical relocation of an anomalous coronary artery originating from the pulmonary artery to the aorta. The procedure involves excising the aberrant coronary artery opening on the pulmonary artery, creating an anastomosis to the aorta to reestablish coronary perfusion, and closing the pulmonary artery defect with a patch graft. This operation is typically performed to restore circulation to the heart and to prevent or correct congestive heart failure in infants with congenital coronary anomalies.
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Service type: Open corrective cardiac surgery for congenital coronary anomaly
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Typical site of service: Inpatient hospital, often in a pediatric cardiac surgery operating room or specialized cardiac surgical unit
Clinical & Coding Specifications
Clinical Context
A 3-week-old term infant presents with feeding intolerance, tachypnea, poor weight gain, and episodes of cyanosis. Echocardiography demonstrates anomalous origin of a coronary artery from the pulmonary artery with evidence of regional myocardial ischemia and early ventricular dysfunction. Cardiac catheterization confirms the anatomy and coronary flow compromise. The surgical team schedules corrective cardiac surgery under general anesthesia in a pediatric cardiothoracic operating room with cardiopulmonary bypass availability. The procedure involves excising the anomalous coronary artery ostium from the pulmonary artery, reimplanting the coronary artery onto the aorta with an anastomosis, and closing the pulmonary artery defect with a patch graft to restore coronary perfusion and prevent progressive congestive heart failure. Perioperative workflow includes preoperative imaging and laboratory evaluation, induction of general anesthesia, median sternotomy, cardiopulmonary bypass and myocardial protection, coronary artery transfer and patch repair, intraoperative transesophageal echocardiography to confirm repair, postoperative transfer to pediatric cardiac intensive care, and staged postoperative surveillance including echocardiography and cardiac enzyme monitoring. Typical site of service is an inpatient tertiary pediatric hospital or pediatric cardiac surgery center.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Standard modifier (no specific CMS definition) | Use per payer rules when no other modifier applies and payer requires explicit default modifier. |