Medical Billing · Nationwide
Adult Congenital Heart Disease (ACHD) & Fontan Conversion Medical Billing Services
Fontan revision and extracardiac conduit conversion, arrhythmia cryoablation Maze add-ons, RVOT conduit and pulmonary valve replacement (PVR), redo sternotomy adhesiolysis, and transcatheter device closure of Fontan fenestrations.
Aethera Healthcare Solutions provides full-service medical billing and revenue cycle management to adult congenital heart disease (ACHD) cardiologists, congenital cardiac surgeons, heart failure teams, and structural heart centers across the United States. We handle coding, claims, payment posting, denial management, and A/R follow-up end to end — so your team can stay focused on patient care while your revenue cycle runs cleanly.
Typical adult congenital heart disease (achd) & fontan conversion CPT range we work: 33735, 33737, 33608, 33475, 33257, 33258, 33530, 33946, 33947, 93580, 93581, 99223.
Why adult congenital heart disease (achd) & fontan conversion billing leaks revenue
Fontan conversion (33737) downcoding clawbacks: Commercial payers downgrading complex Fontan conversion with total cavopulmonary connection (TCPC) and right atrial maze to basic pericardiectomy or isolated conduit revision
Concomitant cryoablation Maze (+33257/+33258) unbundling denials: Health plans rejecting atrial arrhythmia cryoablation add-ons when performed concurrently with open Fontan conversion or conduit revision
Redo sternotomy (+33530) denials in ACHD reoperations: Invalidation of reoperation add-on code +33530 despite documented severe retrosternal mediastinal adhesiolysis in 3rd or 4th redo sternotomies
Hemodynamic diagnostic heart catheterization bundling: Unbundling clawbacks when right/left heart cath (93530) is billed alongside transcatheter pulmonary valve replacement (TPVR)
How Aethera fixes it
Specialty-trained coders (CPC/CCS) code to the documentation
First-pass claim scrubbing against payer and NCCI edits
Proactive denial prevention and 72-hour denial work
Relentless A/R follow-up to drive days-in-A/R down
Eligibility and prior-auth verification before service
Transparent, real-time reporting in the provider portal
Free tools for your billing team
Use these any time — no login required.
Adult Congenital Heart Disease (ACHD) & Fontan Conversion billing FAQ
Can redo sternotomy add-on (+33530) be billed alongside Fontan conversion (33737)?
Yes. Under CMS National Correct Coding Initiative (NCCI) and AMA CPT rules, add-on code +33530 (redo sternotomy or thoracotomy >30 days from prior surgery) is reportable with open Fontan conversion and revision procedures. Operative documentation must specifically detail the dense substernal and epicardial adhesions encountered, dissecting the conduit off the sternal table, and prolonged dissection time before establishing safe cardiopulmonary bypass.
How should surgical cryoablation for atrial tachycardia during Fontan conversion be coded?
When concomitant cryoablation is performed to treat refractory atrial flutter or intra-atrial reentrant tachycardia (IART), add-on code +33257 (operative tissue ablation, limited) or +33258 (extensive) is reported with the primary Fontan revision code (33735/33737). The surgical report must document distinct lesion sets placed across the isthmus, coronary sinus, or atrial wall utilizing cryothermal energy.