Cardiology Coding Alert

Question: The patient is 15 years old and does not have a congenital cardiac anomaly. When the patient was appropriately prepped and anesthetized, my provider selected a site between the xiphoid process and the left sternocostal margin. They created a small incision to reduce needle resistance and then advanced a needle attached to a syringe into the pericardial space. My provider used fluoroscopic imaging guidance to ensure the accuracy of the needle placement. They identified the proper location and aspirated fluid from the pericardial sac into the syringe, after which they withdrew the needle. My provider inserted a catheter through the same puncture site, which they left indwelling for further drainage in case the fluid builds up again. How should I report this procedure?

Pennsylvania 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) on your claim.

On the other hand, if the patient was newborn through five years old or had a congenital cardiac anomaly, you would 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.

Tip: Ultrasound or fluoroscopic imaging is included with this procedure, so do not report it separately.

Don’t miss: Pericardial drainage may be performed to relieve pericardial effusion or cardiac tamponade as well as for diagnostic, palliative, or prophylactic purposes.