Cardiology Coding Alert

Question: My cardiologist performed pericardial drainage on a 15-year-old patient who does not have a congenital cardiac anomaly. He performed this procedure to relieve pericardial effusion. After he prepped and anesthetized the patient, my cardiologist selected a site between the patient’s xiphoid process and the left sternocostal margin. He created a small incision to reduce needle resistance and then advanced a needle attached to a syringe into the pericardial space. Next, my cardiologist used fluoroscopic imaging guidance to ensure accuracy of the needle placement. He identified the proper location and then aspirated fluid from the pericardial sac into the syringe and withdrew the needle. He finally inserted a catheter through the same puncture site, which he left indwelling for further drainage in case the fluid built up again. Which code should I report?

Nevada Subscriber

Answer: You should report 33017 (Pericardial drainage with insertion of indwelling catheter, percutaneous, including fluoroscopy and/or ultrasound guidance, when performed; 6 years and older without congenital cardiac anomaly) in this case.

Don’t miss: Since ultrasound or fluoroscopic imaging is included in code 33017, you should not report imaging separately.

If your cardiologist performs pericardial drainage on a patient who is newborn to five years old or for a patient of any age who has a congenital cardiac anomaly, you should report 33018 (Pericardial drainage with insertion of indwelling catheter, percutaneous, including fluoroscopy and/or ultrasound guidance, when performed; birth through 5 years of age or any age with congenital cardiac anomaly) instead.