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CPT®
0293T

CPT® Code 0293T
Deleted

Official Description

Insertion of left atrial hemodynamic monitor; complete system, includes implanted communication module and pressure sensor lead in left atrium including transseptal access, radiological supervision and interpretation, and associated injection procedures, when performed

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

The CPT® Code 0293T refers to the insertion of a complete system for a left atrial hemodynamic monitor (LAH). This advanced medical device is specifically designed to monitor the left atrial pressure (LAP) in patients suffering from heart failure. The LAH monitor plays a crucial role in the management of fluid status in individuals experiencing acutely decompensated heart failure, allowing for precise measurement of cardiac hemodynamics. The system can function independently or in conjunction with other cardiac devices, such as an implantable cardioverter defibrillator (ICD) or a cardiac resynchronization therapy defibrillator (CRT-D). The LAH monitor comprises several components, including an implanted sensor lead, a subcutaneous antenna coil, and a sealed sensor module equipped with a pressure sensing membrane and circuitry. These components work together to measure and communicate vital parameters such as left atrial pressure, temperature, and intracardiac electrograms. The procedure for inserting this device involves the use of the Seldinger technique, which entails placing sheaths in the right femoral vein and performing a transseptal puncture. Following this, heparin is administered to prevent clotting, and a delivery sheath is positioned in the left atrium to facilitate the implantation of the sensor system. The entire process is conducted under fluoroscopic guidance to ensure accurate placement of the sensor lead and its components. This comprehensive approach to monitoring left atrial pressure is essential for optimizing treatment strategies in heart failure patients.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The insertion of a left atrial hemodynamic monitor is indicated for patients with heart failure, particularly those experiencing acutely decompensated heart failure. The procedure is performed to facilitate the precise measurement of left atrial pressure, which is critical for managing fluid status in these patients.

  • Heart Failure Patients with heart failure require continuous monitoring of hemodynamic parameters to guide treatment decisions and optimize fluid management.
  • Acute Decompensation The procedure is particularly relevant for patients who are acutely decompensated, as accurate monitoring can help prevent further complications.

2. Procedure

The procedure for the insertion of a left atrial hemodynamic monitor involves several critical steps to ensure successful implantation and functionality of the device.

  • Step 1: Accessing the Femoral Vein The procedure begins with the placement of sheaths in the right femoral vein using the Seldinger technique. This technique involves puncturing the skin and accessing the vein with a needle, followed by the insertion of a guide wire and sheath to facilitate further access.
  • Step 2: Performing Transseptal Puncture After establishing access to the femoral vein, a transseptal puncture is performed. This step is crucial as it allows the physician to gain access to the left atrium from the right atrium, enabling the placement of the sensor lead.
  • Step 3: Administering Heparin Following the transseptal puncture, heparin is administered at a dosage of 5000 IU. This anticoagulant is essential to prevent clot formation during the procedure, ensuring a clear pathway for the sensor lead.
  • Step 4: Placing the Delivery Sheath A delivery sheath is then placed in the left atrium. This sheath serves as a conduit for the sensor lead, allowing for its precise placement within the heart.
  • Step 5: Implanting the Sensor System Under fluoroscopic guidance, the sensor lead is advanced until the distal anchor unfolds and makes contact with the left side of the atrial septum. This positioning is critical for accurate pressure measurements.
  • Step 6: Connecting the Antenna Coil Once the sensor lead is properly positioned, the antenna coil is connected to the proximal end of the sensor lead. This coil is then placed in a subcutaneous pocket, completing the implantation process.

3. Post-Procedure

After the insertion of the left atrial hemodynamic monitor, patients are typically monitored for any immediate complications related to the procedure. Post-procedure care may include monitoring vital signs, assessing the insertion site for signs of infection or bleeding, and ensuring the proper functioning of the implanted device. Patients may also receive instructions regarding activity restrictions and follow-up appointments to evaluate the device's performance and the patient's overall condition. It is essential to ensure that the patient understands the importance of regular monitoring and reporting any unusual symptoms to their healthcare provider.
Short Descr INS LT ATRL PRESS MONITOR
Medium Descr INS LT ATRL HEMODYN MOTR CMPLETE SYST W/S&I
Long Descr Insertion of left atrial hemodynamic monitor; complete system, includes implanted communication module and pressure sensor lead in left atrium including transseptal access, radiological supervision and interpretation, and associated injection procedures, when performed
Status Code Carriers Price the Code
Global Days XXX - Global Concept Does Not Apply
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 Inpatient Procedures, not paid under OPPS
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P1G - Major procedure - Other
MUE Not applicable/unspecified.
CCS Clinical Classification 48 - Insertion, revision, replacement, removal of cardiac pacemaker or cardioverter/defibrillator
Date
Action
Notes
2018-01-01 Deleted Deleted Code
2017-12-31 Deleted Code deleted.
2017-01-01 Changed Moderate (Conscious) Sedation flag removed. See new Moderate Sedation category.
2013-01-01 Added First appearance in code book
2013-01-01 Changed Guideline information changed.
2012-01-01 Added Added
Code
Description
Code
Description
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