Summary & Overview
CPT 33745: Intracardiac Shunt Placement with Stent
CPT code 33745 denotes an interventional cardiac catheterization procedure in which an intracardiac shunt is created using one or more stents. The code is used for the initial intracardiac shunt placement and may encompass concurrent diagnostic left and right heart catheterization and target zone angioplasty when performed for congenital cardiac anomalies. This procedure is clinically significant for select structural heart disease and congenital heart defect management and has implications for inpatient and outpatient cardiac care delivery and resource use.
Key payers discussed in this national analysis include Aetna, Blue Cross Blue Shield, Cigna, UnitedHealthcare, and Medicare. Readers will find a concise overview of what 33745 represents, how it is typically performed and where it is delivered, and the common billing modifiers that may accompany claims. The publication provides benchmarks and coding context for the initial intracardiac shunt, highlights clinical situations in which the code is expected to be reported, and summarizes payer coverage patterns and policy considerations relevant to hospitals and interventional cardiology programs.
Data not available in the input for associated taxonomies, specific ICD-10 diagnoses, related codes, and payer-specific reimbursement rates.
Billing Code Overview
CPT code 33745 describes the creation of an intracardiac shunt using one or more stents. The procedure is performed after advancing a catheter through vascular access to the heart under imaging guidance. The description notes that the provider may also perform left and right heart diagnostic cardiac catheterization for congenital cardiac anomalies and target zone angioplasty as part of the initial intracardiac shunt procedure.
Service type: Interventional cardiac catheterization with intracardiac shunt placement
Typical site of service: Hospital inpatient or hospital outpatient catheterization laboratory (cardiac cath lab)
Clinical & Coding Specifications
Clinical Context
A typical patient is a child or young adult with a congenital or acquired intracardiac communication causing symptomatic hypoxemia, cyanosis, or heart failure physiology not amenable to medical therapy alone. An example scenario: a 6-year-old with complex congenital heart disease and refractory systemic desaturation is referred for transcatheter creation of an intracardiac shunt (atrial septostomy or stent-mediated fenestration) to improve cardiac output and systemic oxygenation. The procedure is performed in a cardiac catheterization laboratory under fluoroscopic and echocardiographic guidance. The workflow includes pre-procedure assessment (history, focused exam, echocardiography, pertinent labs), anesthesia evaluation with planned general anesthesia or monitored anesthesia care, vascular access (typically femoral venous and sometimes arterial), diagnostic left and right heart catheterization hemodynamics, transseptal puncture or septal crossing as indicated, deployment of one or more intracardiac stents to create or maintain the shunt, angiography to confirm position and flow, possible adjunctive balloon angioplasty of target zones, device interrogation and hemostasis, and post-procedure monitoring in a pediatric or cardiac step-down unit. Documentation must include indications, informed consent, pre- and post-hemodynamic data, details of stent type and size, imaging guidance used, any diagnostic cardiac catheterization components, and immediate complications or interventions.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Default/unspecified |