© Copyright 2025 American Medical Association. All rights reserved.
The procedure described by CPT® Code 0256T involves the implantation of a catheter-delivered prosthetic aortic heart valve using an endovascular approach. This procedure is specifically indicated for patients with a stenotic aortic heart valve, which is a condition where the valve does not open fully, restricting blood flow from the heart to the aorta. The replacement of the diseased valve is achieved through a minimally invasive technique that utilizes a catheter, typically inserted via the femoral artery. This approach is advantageous as it reduces recovery time and minimizes surgical risks compared to traditional open-heart surgery. The process begins with the preparation of the skin over the access artery, followed by a cutdown to facilitate the insertion of a larger caliber catheter necessary for the transcatheter placement of the prosthetic valve. The procedure includes several critical steps, such as performing a mapping angiogram to assess the suitability of the blood vessels, advancing a guidewire to the aortic valve, and deploying the prosthetic valve into the native valve. The successful placement and function of the valve are confirmed through completion angiography, ensuring that the new valve operates effectively within the patient's cardiovascular system.
© Copyright 2025 Coding Ahead. All rights reserved.
The procedure described by CPT® Code 0256T is indicated for patients with a stenotic aortic heart valve. This condition is characterized by the narrowing of the aortic valve opening, which can lead to significant cardiovascular complications. The replacement of the stenotic valve with a prosthetic valve is necessary to restore normal blood flow from the heart to the aorta and to alleviate symptoms associated with aortic stenosis, such as shortness of breath, chest pain, and fatigue.
The procedure for the implantation of a catheter-delivered prosthetic aortic heart valve via an endovascular approach involves several critical steps. First, the skin over the access artery, typically one of the femoral arteries, is prepped to ensure a sterile environment. A cutdown is performed to expose the artery, allowing for the insertion of a larger caliber catheter necessary for the transcatheter placement of the prosthetic valve. Following this, a mapping angiogram is conducted to evaluate the size and condition of the femoral and iliac arteries, ensuring they can accommodate the larger catheters and are not tortuous. Once the access is confirmed, a guidewire is inserted and advanced through the aorta, positioning it at the aortic valve. A catheter containing a compressed aortic valve within a valve cage is then advanced over the guidewire to the aortic valve site. The compressed valve is positioned within the native diseased aortic valve and deployed. After deployment, the valve cage is removed, and a balloon tip catheter is positioned within the prosthetic valve. The balloon is inflated to properly seat the aortic valve, and the position and function of the valve are verified through imaging. Alternatively, a transeptal approach may be utilized, where the catheter is passed into the right ventricle, the septum is punctured, and the catheter is advanced into the left ventricle to place the prosthetic aortic valve antegrade across the native aortic valve, followed by deployment as previously described. Finally, contrast is injected, and a completion angiography is performed to ensure the proper functioning of the newly implanted valve.
Post-procedure care following the implantation of a catheter-delivered prosthetic aortic heart valve includes monitoring the patient for any immediate complications, such as bleeding or vascular injury at the access site. Patients are typically observed in a recovery area for a specified period before being transferred to a regular hospital room. Continuous cardiac monitoring is essential to assess the function of the newly implanted valve and the overall cardiac status of the patient. Patients may be advised on activity restrictions and follow-up appointments to ensure proper recovery and valve function. Additionally, imaging studies may be scheduled to evaluate the position and performance of the prosthetic valve over time.
| Short Descr | EVASC AORTIC HRT VALVE | Medium Descr | EVASC CATHETER-DELIVRD PROSTH AORTIC HEART VALVE | Long Descr | Implantation of catheter-delivered prosthetic aortic heart valve; endovascular approach | Status Code | Carriers Price the Code | Global Days | YYY - Carrier Determines Whether Global Concept Applies | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 0 - No payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 0 - Payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 1 - Co-surgeons could be paid, though supporting documentation is required... | Team Surgery (66) | 1 - Team surgeons could be paid, though... | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Discontinued Code | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | none | MUE | Not applicable/unspecified. | CCS Clinical Classification | 43 - Heart valve procedures |
Get instant expert-level medical coding assistance.