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The procedure described by CPT® Code 0257T involves the implantation of a catheter-delivered prosthetic aortic heart valve through an open thoracic approach, specifically utilizing either a transapical or transventricular method. This procedure is 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 with a prosthetic valve is achieved through a surgical approach that allows direct access to the heart. In contrast to the transfemoral approach outlined in CPT® Code 0256T, which involves accessing the heart through the femoral artery, the 0257T procedure requires an open thoracotomy, providing a direct pathway to the heart. This method is particularly beneficial for patients who may not be suitable candidates for less invasive techniques due to anatomical considerations or other clinical factors. The procedure involves several critical steps, including the creation of an incision in the thoracic cavity, manipulation of the heart, and precise placement of the prosthetic valve to ensure optimal function and patient outcomes.
© Copyright 2025 Coding Ahead. All rights reserved.
The procedure described by CPT® Code 0257T is indicated for patients with a stenotic aortic heart valve, which is characterized by the narrowing of the valve opening, leading to restricted blood flow from the heart. This condition can result in symptoms such as shortness of breath, chest pain, fatigue, and syncope. The implantation of a prosthetic aortic valve is performed to alleviate these symptoms and improve the patient's quality of life. The open thoracic approach is particularly suitable for patients who may not be candidates for less invasive methods due to anatomical challenges or other health considerations.
The procedure begins with a limited anterolateral left thoracotomy, which is performed at the sixth intercostal space to provide access to the heart. Following the incision, the pericardium is opened to expose the heart. A stab incision is made in the left ventricle, allowing for the introduction of the catheter that will deliver the prosthetic aortic valve. To ensure proper pacing of the heart during the valve delivery, epicardial pacing wires are placed on the left ventricle. Prior to the deployment of the prosthetic valve, the native aortic valve may be dilated using a balloon catheter to facilitate the placement of the new valve. The prosthetic aortic valve is then carefully positioned within the native aortic valve and deployed, ensuring that it is seated correctly for optimal function.
After the implantation of the prosthetic aortic valve, careful monitoring is essential to assess the function of the new valve and the patient's recovery. Patients may require observation in a recovery unit to ensure stable vital signs and to monitor for any potential complications. Follow-up imaging, such as echocardiography, may be performed to evaluate the positioning and function of the prosthetic valve. Additionally, patients will be provided with specific post-operative care instructions, including activity restrictions and medication management, to support their recovery and ensure optimal outcomes.
| Short Descr | OPN TTHRC AORTIC HRT VALVE | Medium Descr | OPEN THORACIC CATHETER DELIVD AORTIC HEART VALVE | Long Descr | Implantation of catheter-delivered prosthetic aortic heart valve; open thoracic approach (eg, transapical, transventricular) | 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 |
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