Summary & Overview
CPT 33822: Pediatric Ductus Division and Major Vessel Repair
CPT code 33822 denotes a pediatric surgical procedure to repair an opening between the major blood vessels leaving the heart by dividing the ductus and suturing the vessel stumps. This is a specialized cardiovascular operation typically performed in inpatient pediatric cardiac operating rooms at tertiary hospitals and children’s medical centers. The code is age-specific and applies to patients under 18 years.
Nationally, the code matters because it captures a high-acuity, resource-intensive pediatric cardiac surgical service that influences hospital surgical case mix, inpatient resource utilization, and payer coverage policies for congenital heart procedure management. Key payers in the national context include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will learn what CPT code 33822 represents clinically, the typical service and site of care associated with the code, and the payer landscape relevant to reimbursement and coverage discussions. The publication covers benchmarks where available, policy and coverage considerations that affect access and billing for pediatric cardiac repair, and clinical context explaining when this operation is used. Data not available in the input will be noted where applicable.
Billing Code Overview
CPT code 33822 describes a surgical repair that closes an opening between the major blood vessels leading from the heart. The procedure involves dividing the ductus (the opening between the vessels) and suturing the stumps of the vessels together. This code is reported for patients younger than 18 years old.
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Service type: Pediatric cardiovascular surgical repair of ductal connection
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Typical site of service: Inpatient surgical setting, pediatric cardiac operating room or tertiary care hospital
Clinical & Coding Specifications
Clinical Context
A typical patient is an infant or child diagnosed with a patent ductus arteriosus (PDA) causing significant left-to-right shunt, failure to thrive, respiratory distress, or risk of pulmonary overcirculation. The child is referred by a pediatric cardiologist after echocardiographic confirmation of a hemodynamically significant PDA and medical management attempts (e.g., indomethacin or ibuprofen) have failed or are contraindicated. Preoperative workflow includes history and physical, echocardiography, chest X-ray, baseline laboratory testing, anesthesia evaluation, and informed consent from caregivers. The procedure is performed in an operating room or pediatric cardiac catheterization suite under general anesthesia with pediatric cardiac surgical team present. Intraoperative steps include median sternotomy or thoracotomy exposure, identification of the ductus arteriosus, surgical division of the ductus and oversewing of the aortic and pulmonary stumps, hemostasis, and closure. Postoperative care includes transfer to a pediatric cardiac intensive care unit for hemodynamic monitoring, ventilatory support as needed, pain control, and follow-up echocardiography to confirm closure. Typical payors involved in authorization and billing include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, BUCA, and Medicare.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier | Use when no additional reporting modifier applies. |