Medical Billing · Nationwide
Pediatric Single-Ventricle Congenital Heart Disease Palliation (Norwood / Glenn / Fontan) Medical Billing Services
Multi-stage surgical reconstruction for hypoplastic left heart syndrome (HLHS) and single ventricle anomalies: Stage 1 Norwood neo-aorta reconstruction and Sano/BT systemic-to-pulmonary shunt (33619/33688/33750), Stage 2 bidirectional cavopulmonary Glenn shunt (33767), Stage 3 extracardiac conduit Fontan completion (33737), delayed sternal closure (+33530), and temporary ECMO/ECLS circulatory support (+33946/+33947).
Aethera Healthcare Solutions provides full-service medical billing and revenue cycle management to pediatric congenital heart surgeons, pediatric cardiothoracic surgical specialists, pediatric cardiac intensivists, and congenital 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 pediatric single-ventricle congenital heart disease palliation (norwood / glenn / fontan) CPT range we work: 33619, 33688, 33750, 33766, 33767, 33737, 33530, 33946, 33947, 99291, 99292.
Why pediatric single-ventricle congenital heart disease palliation (norwood / glenn / fontan) billing leaks revenue
Multi-stage global surgery clawbacks: Payers improperly denying Stage 2 Glenn or Stage 3 Fontan claims within the 90-day global surgical window of prior palliation absent Modifier -58
Concomitant pulmonary artery reconstruction (+33688) bundling: Clearinghouses bundling complex branch pulmonary artery patch angioplasty into primary Norwood neo-aorta repair
Delayed sternal closure (+33530) unbundling audits during open-chest postoperative hemodynamic recovery
Neonatal cardiac critical care (99291/99292) downcoding during high-risk post-Norwood physiology
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.
Pediatric Single-Ventricle Congenital Heart Disease Palliation (Norwood / Glenn / Fontan) billing FAQ
How is Stage 1 Norwood reconstruction coded under CPT guidelines?
Stage 1 Norwood reconstruction for hypoplastic left heart syndrome is reported using CPT 33619 (repair of single ventricle with aortic arch reconstruction). Systemic-to-pulmonary blood flow establishment using a modified Blalock-Taussig shunt (33750) or right ventricle-to-pulmonary artery conduit (Sano shunt 33766) is separately billable depending on the specific surgical strategy. Extensive branch pulmonary artery reconstruction is reported using add-on code +33688.
Can delayed sternal closure (+33530) be billed separately following pediatric cardiac surgery?
Yes. When extreme myocardial edema or tenuous neonatal hemodynamics prevent primary sternal closure, delayed sternal closure performed on postoperative Day 2 to 5 is separately reimbursable using CPT +33530 (delayed sternal closure) with Modifier -58 when properly documented in the staged surgical plan.