Summary & Overview
CPT 33814: Aortopulmonary Defect Repair with Cardiopulmonary Bypass
Headline: CPT code 33814: Surgical repair of aortopulmonary defect using cardiopulmonary bypass
Lead: CPT code 33814 denotes the open surgical obliteration or correction of an aortopulmonary defect performed with cardiopulmonary bypass. This cardiac procedure addresses pathologic communication between the ascending aorta and the pulmonary artery and is typically performed in an inpatient operating room during cardiac surgery.
What this code represents and why it matters: CPT code 33814 captures a complex, resource-intensive congenital or structural heart repair requiring cardiopulmonary bypass. As a high-acuity surgical intervention, it has implications for hospital resource utilization, perioperative care pathways, and payer coverage policies. Accurate coding of this procedure is critical for clinical documentation, quality measurement, and reimbursement alignment across national payers.
Key payers covered: The analysis considers major national payers including Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
What readers will learn: The publication provides clinical context for the procedure, outlines typical sites of service and service type, and summarizes payer coverage patterns and benchmark considerations where available. It also highlights common billing modifiers and coding considerations for complex cardiac surgery. Data not available in the input will be noted explicitly where applicable.
Billing Code Overview
CPT code 33814 describes a surgical procedure to obliterate or correct an aortopulmonary defect, an abnormal communication between the ascending aorta and the pulmonary artery. The procedure is performed using cardiopulmonary bypass and addresses a congenital or acquired cardiac shunt that permits blood flow between the systemic and pulmonary circulations.
Service Type: Open cardiac surgical repair using cardiopulmonary bypass
Typical Site of Service: Inpatient operating room or cardiac surgery suite
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 6-year-old child presents with signs of congestive heart failure, poor growth, and a continuous “machinery” murmur noted on cardiac auscultation. Diagnostic workup includes transthoracic echocardiography demonstrating an aortopulmonary window (a persistent communication between the ascending aorta and the main pulmonary artery) with significant left-to-right shunt and pulmonary overcirculation. The cardiothoracic surgical team schedules the patient for corrective open-heart surgery. The patient is admitted to an inpatient pediatric cardiothoracic unit, undergoes general endotracheal anesthesia, median sternotomy, institution of cardiopulmonary bypass, direct visualization of the aortopulmonary defect, and surgical obliteration (patch closure or primary repair) of the defect. Postoperative care includes intensive care monitoring, ventilatory support as needed, pain control, inotropic support for cardiac function, serial echocardiography to confirm repair integrity, and step-down to the pediatric ward prior to discharge. Typical documentation includes preoperative evaluation, anesthesia record, cardiopulmonary bypass record, operative note describing the defect and repair method, and postoperative progress notes.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Anesthesia group code (historical) | Rarely used; not applicable for surgical CPT reporting—present in input but not typically appended to 33814. |