Summary & Overview
CPT 33606: Pulmonary Artery to Aorta Join for Double Inlet Ventricle
CPT code 33606 denotes an open cardiac surgical repair that connects the pulmonary artery to the aorta to correct double inlet ventricle, a rare congenital heart defect in which a single functional left ventricle receives inflow from both great vessels. This operative intervention is clinically significant because it addresses abnormal hemodynamics and reduces volume overload of the solitary ventricle, affecting short-term perioperative risk and long-term cardiac function. Nationally, the procedure is performed in specialized pediatric and congenital heart centers and has implications for hospital resource use, intensive care needs, and payer coverage for complex congenital cardiac surgery.
Key payers considered in this overview include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for the procedure, typical site-of-service expectations, and an outline of topics relevant to reimbursement and coverage discussions. The publication provides benchmarks where available, summarizes common billing and service-line considerations for inpatient cardiac surgery, and highlights policy and payer coverage themes that affect access and authorization for high-complexity congenital cardiac procedures. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 33606 describes a cardiac surgical procedure in which the surgeon joins the pulmonary artery to the aorta to correct a congenital deformity known as double inlet ventricle. In this congenital condition the patient has a single functional ventricle (the left ventricle) that receives blood flow from both the aorta and the pulmonary artery; the procedure reduces excessive blood flow into the solitary ventricle and redirects circulation.
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Service type: Pediatric/congenital cardiac surgical correction (open cardiac surgery)
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Typical site of service: Inpatient hospital setting, typically performed in an operating room with postoperative intensive care for cardiothoracic surgery
Clinical & Coding Specifications
Clinical Context
A typical patient is an infant or young child diagnosed with a complex single-ventricle congenital heart defect such as double inlet left ventricle (DILV) causing volume overload of the solitary functional ventricle and excessive pulmonary blood flow. The child is referred from pediatric cardiology for corrective surgical palliation aimed at reducing pulmonary overcirculation and protecting ventricular function. Preoperative workflow includes detailed echocardiography, cardiac catheterization for hemodynamic assessment, laboratory evaluation, and multidisciplinary conference with pediatric cardiac surgery, anesthesia, and intensive care teams. On the day of service the patient undergoes general endotracheal anesthesia in a pediatric cardiac operating room. The surgeon performs median sternotomy, cardiopulmonary bypass, and construction of an anastomosis joining the pulmonary artery to the aorta (systemic-pulmonary artery anastomosis) as part of staged single-ventricle palliation. Postoperative workflow includes transfer to pediatric cardiac intensive care, mechanical ventilation management, inotropic support as indicated, serial echocardiography to assess shunt function, and staged planning for subsequent procedures such as a bidirectional Glenn or Fontan circulation as clinically indicated.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier; standard reporting | Use when no circumstances require modifier reporting. |