Summary & Overview
CPT 33780: Arterial Switch (Jatene) for Transposition of Great Arteries
Headline: CPT code 33780 defines the arterial switch (Jatene) procedure for correcting transposition of the great arteries.
CPT code 33780 represents an open congenital cardiac surgery that corrects transposition of the great arteries by switching the aorta and pulmonary artery and closing a ventricular septal defect when present. This code captures a high-acuity, resource-intensive pediatric cardiac procedure that has significant implications for surgical planning, inpatient resource allocation, and payer coverage policies across the United States.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna, UnitedHealthcare, and Medicare. Readers will find a concise operational and clinical context for billing and reimbursement considerations, common modifiers used with the code, typical site-of-service expectations, and the clinical significance of the arterial switch in neonatal and infant congenital heart disease management.
The publication provides benchmarks and policy-relevant context at a national level: frequency and utilization drivers for high-complexity congenital cardiac surgery, typical payer coverage patterns, and coding nuances relevant to hospital revenue cycle teams and pediatric cardiothoracic surgical programs. Data not provided in the input are noted where applicable; clinical coding teams should reference local payer policy manuals for coverage specifics.
Billing Code Overview
CPT code 33780 describes a surgical repair for congenital transposition of the great arteries, commonly known as an arterial switch or Jatene procedure. The operation corrects a congenital cardiac defect in which the aorta arises from the right ventricle and the pulmonary artery arises from the left ventricle by switching the transposed or abnormally attached great arteries and closing a ventricular septal defect when present.
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Service type: Open cardiac congenital corrective surgery (arterial switch/Jatene procedure)
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Typical site of service: Inpatient hospital setting, commonly performed in pediatric cardiac surgery centers or tertiary care hospitals for neonates and infants
Clinical & Coding Specifications
Clinical Context
A full-term neonate is diagnosed with d-transposition of the great arteries (TGA) in the newborn nursery after cyanosis and an abnormal echocardiogram. The infant is stabilized with prostaglandin E1 infusion to maintain ductal patency and may undergo balloon atrial septostomy in the catheterization lab to improve mixing. Once stabilized and evaluated by pediatric cardiology and cardiothoracic surgery, the infant is scheduled for an arterial switch (Jatene) procedure (33780) in the pediatric cardiac operating room under general anesthesia. The surgical team performs median sternotomy, cardiopulmonary bypass, transection and translocation of the aorta and pulmonary artery to correct ventriculo-arterial discordance, and closure of an associated ventricular septal defect if present. Postoperative care includes intensive care unit monitoring for hemodynamics, respiratory support, inotropic support as needed, serial echocardiography to assess coronary artery reimplantation and ventricular function, and staged transition to the neonatal ward prior to discharge. Typical workflow involves preoperative evaluation (imaging, labs), intraoperative procedure 33780, and postoperative critical care with multidisciplinary coordination among pediatric cardiology, cardiothoracic surgery, anesthesiology, and neonatal nursing services.
Coding Specifications
| Modifier | Description | When to Use |
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