Summary & Overview
CPT 33741: Transcatheter Atrial Septostomy for Congenital Heart Defect
CPT code 33741 identifies transcatheter atrial septostomy, a catheter-based procedure that creates an opening between the atria to improve atrial flow in patients with congenital heart defects. This procedure is performed under imaging guidance with catheter access through a vessel into the right heart. Nationally, the code is relevant to interventional cardiology, pediatric cardiology and congenital heart disease programs where percutaneous approaches are used to palliate or manage atrial-level shunting.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna, UnitedHealthcare and Medicare. Readers will find clinical context for when a transcatheter atrial septostomy is performed, typical sites of service, and common billing considerations tied to the procedure. The publication summarizes how payers commonly classify and reimburse catheter-based intracardiac interventions, highlights typical care settings (hospital catheterization labs and interventional suites), and outlines benchmarking and policy topics that affect coding consistency and coverage determinations.
The content is intended to help coding managers, billing specialists, and clinical program leaders understand the procedural definition and payer landscape for CPT code 33741, and to provide a concise reference for clinical and administrative discussions about transcatheter atrial septostomy.
Billing Code Overview
CPT code 33741 describes a transcatheter atrial septostomy procedure. In this intervention, a clinician inserts a vascular catheter and advances it into the right side of the heart under imaging guidance, then creates an opening between the atria (the heart's upper chambers) to improve atrial flow in patients with a congenital cardiac defect.
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Service type: Transcatheter cardiac septostomy (catheter-based intracardiac intervention)
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Typical site of service: Hospital cardiac catheterization laboratory or interventional cardiology suite
Clinical & Coding Specifications
Clinical Context
A typical patient is an infant or child with a congenital atrial septal defect (ASD) or other cardiac birth defect causing inadequate atrial communication and resulting in right-sided volume overload, cyanosis, or failure to thrive. The patient presents to a pediatric cardiology clinic or emergency department after screening or symptomatic evaluation; diagnostic transthoracic echocardiography and cardiac catheterization confirm anatomy amenable to transcatheter atrial septostomy. Under general anesthesia or conscious sedation in a cardiac catheterization laboratory or hybrid operating room, an interventional cardiologist gains vascular access (commonly femoral vein), advances a catheter into the right atrium under fluoroscopic and echocardiographic guidance, and creates or enlarges an atrial communication (balloon atrial septostomy or blade/stent septostomy as indicated) to improve atrial flow and systemic oxygenation. Post-procedure monitoring occurs in a post-anesthesia care unit or pediatric intensive care unit with follow-up echocardiography to assess septal defect size and hemodynamic effect. Providers coordinating care include interventional pediatric cardiology, anesthesia, cath lab nursing and radiology technologists, with billing reflecting the transcatheter septostomy procedure and any adjunctive imaging or device placement.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
11 | Standard office or outpatient service | When this procedure is billed under usual circumstances without unusual service intensity |