Summary & Overview
CPT 33746: Additional Transcatheter Intracardiac Shunt Creation
CPT code 33746 denotes the creation of an additional transcatheter intracardiac shunt using one or more stents during the same session as the initial shunt placement. This code is specific to additional shunts and can be reported once per additional shunt created. It is clinically relevant for procedures addressing congenital cardiac anomalies where intracardiac shunts and targeted angioplasty are performed in a catheterization setting.
Key national payers in scope include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the clinical procedure captured by the code, typical sites of service, and the service category. The publication outlines how the code is used in claims reporting, common modifiers associated with related interventional services, and where CPT code 33746 fits within interventional cardiology coding practice. It also summarizes common billing considerations for sessions that include diagnostic left and right heart catheterization and target zone angioplasty performed alongside shunt creation.
This summary serves health policy analysts, coding professionals, and hospital billing teams seeking a national-level reference for CPT code 33746, its clinical context, and the primary payers that typically cover such interventional cardiology procedures. Data not available in the input on diagnoses, associated taxonomies, and related codes is not included.
Billing Code Overview
CPT code 33746 describes the creation of an additional transcatheter intracardiac shunt at the same session as the initial shunt placement. The procedure involves forming one or more additional intracardiac shunts using stents and may include left and right heart diagnostic cardiac catheterization for congenital cardiac anomalies and target zone angioplasty. Report CPT code 33746 once for each additional intracardiac shunt created during the same session.
Service type: Transcatheter intracardiac shunt creation (additional shunt) with possible diagnostic cardiac catheterization and target zone angioplasty
Typical site of service: Hospital catheterization laboratory or specialized interventional cardiology suite
Clinical & Coding Specifications
Clinical Context
A pediatric or adult congenital heart disease patient undergoes placement of a transcatheter intracardiac shunt to palliate or correct abnormal intracardiac flow (for example, creation of a controlled interatrial or interventricular communication). During the same session, the interventional cardiology team creates an additional intracardiac shunt using one or more stents and documents placement of each additional shunt. Typical workflow: pre-procedure evaluation with history, focused exam and echocardiography review; informed consent addressing combined procedures; transport to a cardiac catheterization laboratory; general anesthesia or conscious sedation per patient age and complexity; vascular access and right and/or left heart catheterization as needed; deployment of the initial transcatheter shunt device followed by placement of one or more additional stent-supported shunts (33746 reported once for each additional shunt); completion angiography and hemodynamic assessment; closure or management of access sites and post-procedure recovery with monitoring for bleeding, arrhythmia, or hemodynamic instability. Typical site of service is an inpatient or outpatient cardiac catheterization laboratory within an acute care hospital or specialized pediatric cardiac center. Common clinical indications include congenital cardiac anomalies requiring controlled intracardiac communications, severe pulmonary hypertension with need for atrial septostomy, or staged palliation in complex single-ventricle physiology where multiple shunts are created in a single session.
Coding Specifications
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