Summary & Overview
CPT 33775: Atrial Baffle Repair for Transposition of the Great Arteries
CPT code 33775 denotes an open congenital cardiac repair (Mustard or Senning type) that constructs an atrial baffle to correct transposition of the great arteries and includes cardiopulmonary bypass and removal of a prior pulmonary artery band when applicable. This complex, resource-intensive procedure is performed in specialized cardiac surgical centers and has importance for national surgical capacity, pediatric cardiac outcomes, and payer coverage policies. Key payers commonly involved in coverage and reimbursement for this procedure include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical description, typical site-of-service expectations, and an overview of common billing considerations. The publication summarizes benchmarking considerations for high-acuity congenital cardiac surgery, highlights relevant policy and coding notes that affect claims processing, and provides clinical context to aid revenue cycle and clinical teams in aligning documentation with code intent. Data not available in the input is noted where specific payer benchmarks, associated taxonomies, ICD-10 diagnoses, related codes, and service-line details are not provided.
Billing Code Overview
CPT code 33775 describes a surgical repair for a congenital cardiac malformation in which the aorta arises from the right ventricle and the pulmonary artery arises from the left ventricle. The procedure constructs an intra-atrial baffle or tunnel, using pericardium or atrial valve tissue, to redirect deoxygenated blood to the pulmonary circulation and oxygenated blood to the systemic circulation. The operation is performed on cardiopulmonary bypass and includes removal of a previously placed pulmonary artery band when present. This operation is also referred to as a Mustard or Senning type procedure.
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Service type: Surgical congenital cardiac repair (atrial baffle/tunneling procedure) performed on cardiopulmonary bypass
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Typical site of service: Inpatient hospital operating room with cardiothoracic surgical capabilities and postoperative intensive care
Clinical & Coding Specifications
Clinical Context
A typical patient is a pediatric or young adult with dextro-transposition of the great arteries (d-TGA) who previously underwent pulmonary artery banding or other staged palliation and now requires definitive intra-atrial baffle repair (Mustard or Senning-type) with removal of a prior pulmonary artery band. The patient is brought to the operating room after preoperative evaluation in cardiology and cardiac surgery clinics, with imaging (echocardiography, cardiac MRI or CT) confirming anatomy and function. Preoperative steps include anesthesia evaluation, informed consent, cross-matching blood, and placement of invasive monitoring. The cardiac surgeon performs a median sternotomy, places the patient on cardiopulmonary bypass, constructs an intra-atrial baffle or tunnel using autologous pericardium or atrial tissue to redirect systemic and pulmonary venous return, and removes the prior pulmonary artery band. The procedure may require concurrent arrhythmia assessment and repair of associated defects. Postoperative care occurs in a pediatric or cardiothoracic intensive care unit with hemodynamic monitoring, ventilatory support as needed, inotropic support, and early echocardiographic assessment to confirm baffle integrity and flow. Typical payors for authorization and claims include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, BUCA, and Medicare.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Service not specified | Data not available in the input. |
| Service was performed as planned (no complications) | Use when the operation proceeded as scheduled without unplanned return to the operating room.