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The CPT® Code 0266T refers to the procedure of implantation or replacement of a carotid sinus baroreflex activation device, which is a specialized medical device used to treat patients suffering from refractory hypertension. This condition is characterized by high blood pressure that does not respond adequately to standard medical treatments. The carotid sinus baroreflex plays a crucial role in regulating arterial blood pressure and heart rate by sending electrical signals to the brainstem, which in turn modulates the autonomic nervous system's output to maintain blood pressure within a normal range. In patients with refractory hypertension, the functionality of this reflex is compromised, leading to persistent high blood pressure. The implantation of the baroreflex activation device aims to enhance the electrical activity of the carotid baroreceptor afferent nerves. By doing so, the device mimics the natural response of the carotid sinus to elevated blood pressure, prompting the central nervous system to adjust sympathetic and vagal nerve activity. This adjustment results in a decrease in both blood pressure and heart rate. The procedure involves the careful placement of electrodes on the carotid sinus wall, which requires precise surgical techniques to ensure the safety and effectiveness of the device. The entire process includes generator placement, lead placement (which can be unilateral or bilateral), intra-operative interrogation, programming of the device, and any necessary repositioning to achieve optimal results.
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The implantation or replacement of a carotid sinus baroreflex activation device is indicated for patients with refractory hypertension, which is defined as high blood pressure that remains uncontrolled despite the use of multiple antihypertensive medications. This procedure is specifically designed for individuals who have not achieved adequate blood pressure control through conventional treatment methods and may benefit from the modulation of their autonomic nervous system to lower blood pressure and heart rate.
The procedure for the implantation or replacement of a carotid sinus baroreflex activation device involves several critical steps to ensure proper placement and functionality of the device.
Post-procedure care involves monitoring the patient for any immediate complications and ensuring that the device is functioning as intended. Patients may require follow-up visits to assess the effectiveness of the device in managing their blood pressure and to make any necessary adjustments to the programming of the impulse generator. It is essential to provide the patient with instructions regarding activity restrictions, wound care, and signs of potential complications that should prompt immediate medical attention. Regular follow-up appointments will help in evaluating the long-term efficacy of the device and the overall management of the patient's hypertension.
| Short Descr | IMPLT/RPL CRTD SNS DEV TOTAL | Medium Descr | IM/REPL CARTD SINUS BAROREFLX ACTIV DEV TOT SYST | Long Descr | Implantation or replacement of carotid sinus baroreflex activation device; total system (includes generator placement, unilateral or bilateral lead placement, intra-operative interrogation, programming, and repositioning, when performed) | 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) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Procedure or Service, Not Discounted when Multiple | ASC Payment Indicator | Device-intensive procedure added to ASC list in CY 2008 or later; paid at adjusted rate. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | T2D - Other tests - other | MUE | 1 | CCS Clinical Classification | 59 - Other OR procedures on vessels of head and neck |
| 82 | Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s). | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | 22 | Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service. | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | GC | This service has been performed in part by a resident under the direction of a teaching physician | GW | Service not related to the hospice patient's terminal condition | LT | Left side (used to identify procedures performed on the left side of the body) | Q0 | Investigational clinical service provided in a clinical research study that is in an approved clinical research study | RT | Right side (used to identify procedures performed on the right side of the body) | X5 | Diagnostic services requested by another clinician: for reporting services by a clinician who furnishes care to the patient only as requested by another clinician or subsequent and related services requested by another clinician; this modifier is reported for patient relationships that may not be adequately captured by the above alternative categories; reporting clinician service examples include but are not limited to, the radiologist's interpretation of an imaging study requested by another clinician |
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| 2012-01-01 | Added | First appearance in code book |
| 2011-07-01 | Added | Code implemented |
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