Summary & Overview
CPT 33916: Pulmonary Thromboendarterectomy for Chronic Thromboembolic Pulmonary Hypertension
CPT code 33916 denotes a pulmonary thromboendarterectomy — a cardiothoracic surgical procedure performed with cardiopulmonary bypass to remove chronic thromboembolic occlusions from the pulmonary arteries and treat chronic thromboembolic pulmonary hypertension. This code captures a high-acuity, resource-intensive inpatient operation with implications for tertiary care centers that provide advanced pulmonary vascular surgery. Nationally, accurate coding for 33916 affects facility billing, case mix classification, and access to specialized surgical care for patients with chronic thromboembolic disease.
Key payers addressed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context for 33916, typical sites and service characteristics, and the payer landscape relevant to coverage and claims processing. The publication summarizes common billing considerations, coding practice implications, and service-line positioning for cardiothoracic and vascular surgery programs. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 33916 describes a surgical pulmonary thromboendarterectomy procedure in which the provider removes chronic thromboembolic material from the pulmonary arteries and may perform an embolectomy. The operation is performed with cardiopulmonary bypass to treat chronic thromboembolic pulmonary hypertension caused by persistent clots obstructing blood flow in the lungs.
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Service type: Surgical, cardiothoracic vascular procedure
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Typical site of service: Inpatient hospital operating room with cardiopulmonary bypass support
Clinical & Coding Specifications
Clinical Context
A 52-year-old patient with progressive exertional dyspnea, fatigue, and signs of right heart strain is referred to a cardiothoracic surgery program after multimodal workup demonstrates chronic thromboembolic pulmonary hypertension (CTEPH) with organized thromboembolic material within the main and lobar pulmonary arteries. Right heart catheterization confirms elevated pulmonary artery pressures and vascular resistance. After multidisciplinary review (pulmonary hypertension specialist, cardiothoracic surgeon, and anesthesiology), the patient is scheduled for pulmonary thromboendarterectomy (pulmonary artery embolectomy) under general anesthesia with cardiopulmonary bypass.
Preoperative workflow includes optimization of right heart function, anticoagulation management, imaging review (CT pulmonary angiography, ventilation/perfusion scan), and informed consent focused on risks of major thoracic surgery and cardiopulmonary bypass. Intraoperative steps include median sternotomy, institution of cardiopulmonary bypass, circulatory arrest as needed for precise endarterectomy of organized clots from the pulmonary arteries, hemostasis, and weaning from bypass. Postoperative care involves intensive care monitoring, pulmonary vasodilator management if indicated, anticoagulation resumption, and surveillance for reperfusion lung injury and right ventricular recovery. The procedure is billed using 33916 for surgical removal of chronic thromboembolic material with cardiopulmonary bypass.
Coding Specifications
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