August 01, 2022

Exchange plans and Commercial plans: New 2022 codes for Pediatric Congenital Heart Disease

Beginning Jan. 1, 2022, there are new Current Procedural Terminology (CPT®) codes in place for Pediatric Congenital Heart Disease:

  • Endovascular Repair of Congenital Heart and Vascular Defects (33894, 33895, and 33897)
  • Cardiac Catheterization for Congenital Defects (93593, 93594, 93595, 93596, 93597) – replacing codes 93530-93533, which are no longer valid.

Affected States
These CPT code changes affect all Employer & Individual plans and Exchange plans in the following states:

  • Alabama
  • Arizona
  • Florida
  • Georgia
  • Illinois
  • Louisiana
  • Maryland
  • Michigan
  • North Carolina
  • Oklahoma
  • Tennessee
  • Texas
  • Virginia
  • Washington

The new codes and their descriptions are listed below.

Cardiac Catheterization for Congenital Defects CPT Codes

CPT code Code description
93593 Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; normal native connections
93594 Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; abnormal native connections
93595 Left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone, normal or abnormal native connections
93596 Right and left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone(s); abnormal native connections
93597 Right and left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone(s); abnormal native connections
93598 Cardiac output measurement(s), thermodilution or other indicator dilution method, performed during cardiac catheterization for the evaluation of congenital heart defects (List separately in addition to code for primary procedure)

Endovascular Repair of Congenital Heart and Vascular Defects CPT Codes

CPT code Code description

33894

Endovascular stent repair of coarctation of the ascending, transverse, or descending thoracic or abdominal aorta, involving stent placement; across major side branches
33895 Endovascular stent repair of coarctation of the ascending, transverse, or descending thoracic or abdominal aorta, involving stent placement; not crossing major side branches
33897 Percutaneous transluminal angioplasty of native or recurrent coarctation of the aorta

Questions?
For more information, review the American College of Cardiology’s article announcing the new codes. 

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