Summary & Overview
CPT 33507: Surgical Repair of Anomalous Coronary Artery Origin
CPT code 33507 captures surgical reimplantation or unroofing/reconstruction of an anomalous coronary artery that arises within the aortic wall. This rare but clinically significant procedure addresses a congenital coronary artery anomaly that can lead to myocardial ischemia and sudden cardiac death if untreated. As a specialized cardiac operation performed in operative and inpatient settings, CPT code 33507 is important for accurate procedural classification, hospital case-mix reporting, and payment adjudication for high-acuity cardiac surgery.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for the procedure, typical sites of service, common payer coverage patterns, and guidance on where to look for benchmarks and policy language. The publication outlines what stakeholders need to track nationally: utilization patterns for rare congenital cardiac repairs, coding clarity for operative technique descriptions, and payer policy considerations that affect authorization and facility reimbursement. The resource summarizes available clinical framing and notes where input data is missing, while directing readers to payer contracts and Medicare rules for definitive coverage and billing requirements.
Billing Code Overview
CPT code 33507 describes surgical correction of an anomalous coronary artery originating within the wall of the aorta, in which the provider relocates the opening or origin of the anomalous artery to a more anatomical position. The procedure can involve removal of a portion of the artery wall and reconnection of the coronary artery to the aorta, or probing the coronary artery and creating an opening to connect it to the aorta.
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Service type: Cardiac surgical repair of anomalous coronary artery origin
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Typical site of service: Inpatient cardiac surgery operating room (tertiary care center or cardiac surgical unit)
Data not available in the input for associated taxonomies, specific ICD-10 diagnoses, or related codes.
Clinical & Coding Specifications
Clinical Context
A 16-year-old adolescent presents after episodes of exertional syncope and near-syncope. Noninvasive testing including exercise stress testing and echocardiography suggests ischemia; coronary CT angiography demonstrates an anomalous origin of the right coronary artery arising from the left coronary cusp with an intramural aortic course and slit-like ostium. Cardiothoracic surgery is consulted. The clinical workflow includes preoperative cardiology evaluation, cross-sectional coronary imaging confirmation, anesthetic evaluation, informed consent discussing risk of sudden cardiac death, and scheduling for surgical correction. In the operating room under general endotracheal anesthesia, a median sternotomy and cardiopulmonary bypass are used. The surgeon mobilizes the aorta and anomalous coronary artery, excises a portion of the intramural wall, and reimplants or creates a neo-ostium to relocate the coronary origin to a more anatomical position. Postoperative care includes ICU monitoring, serial cardiac enzymes, echocardiography to assess coronary flow and ventricular function, pain control, and discharge planning with cardiac rehabilitation and follow-up imaging to confirm repair integrity.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier—routine reporting | Use when no special circumstances apply; standard reporting of the procedure. |