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Transcatheter renal sympathetic denervation is a minimally invasive procedure aimed at treating conditions such as hypertension, heart failure, renal dysfunction, and sleep apnea, particularly when traditional lifestyle modifications and pharmacological treatments have proven ineffective. The underlying principle of this procedure is based on the understanding that heightened activity of the sympathetic nervous system, originating from the renal plexus, significantly contributes to the development of hypertension. By disrupting the nerve impulses from the renal plexus, this procedure effectively reduces sympathetic nervous system activity, thereby lowering blood pressure. The transcatheter approach allows for the delivery of low-level radiofrequency energy directly through the renal artery wall to target the sympathetic nerves associated with the kidney. This technique begins with the preparation of the skin over the access artery, typically one of the femoral arteries, followed by arterial puncture and the placement of a sheath. Heparin is administered to prevent clotting during the procedure. A guide wire is then navigated from the access artery into the aorta, positioning it appropriately for subsequent imaging and interventions. The procedure includes the use of fluoroscopy and contrast injections to visualize the renal vasculature, ensuring accurate catheter placement and effective treatment delivery. Ultimately, this innovative procedure represents a significant advancement in the management of resistant hypertension and related conditions.
© Copyright 2025 Coding Ahead. All rights reserved.
The transcatheter renal sympathetic denervation procedure is indicated for the following conditions:
The transcatheter renal sympathetic denervation procedure involves several critical steps to ensure effective treatment:
Following the completion of the transcatheter renal sympathetic denervation procedure, patients typically require monitoring for any immediate complications related to the vascular access site. It is essential to apply pressure to the access site to prevent bleeding. Patients may experience some discomfort or bruising at the puncture site, which usually resolves within a few days. The healthcare team will provide instructions regarding activity restrictions and follow-up appointments to assess the effectiveness of the procedure and monitor blood pressure levels. Long-term follow-up is crucial to evaluate the sustained impact of the renal sympathetic denervation on hypertension and related conditions.
| Short Descr | TRNSCTH RENAL SYMP DENRV BIL | Medium Descr | TRANSCATHETER RENAL SYMPATH DENERVATION BILAT | Long Descr | Transcatheter renal sympathetic denervation, percutaneous approach including arterial puncture, selective catheter placement(s) renal artery(ies), fluoroscopy, contrast injection(s), intraprocedural roadmapping and radiological supervision and interpretation, including pressure gradient measurements, flush aortogram and diagnostic renal angiography when performed; bilateral | Status Code | Carriers Price the Code | Global Days | YYY - Carrier Determines Whether Global Concept Applies | PC/TC Indicator (26, TC) | 9 - Not Applicable | Multiple Procedures (51) | 9 - Concept does not apply. | Bilateral Surgery (50) | 9 - Concept does not apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 9 - Concept does not apply. | Co-Surgeons (62) | 9 - Concept does not apply. | Team Surgery (66) | 9 - Concept does not apply. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Hospital Part B services paid through a comprehensive APC | 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) | P6C - Minor procedures - other (Medicare fee schedule) | MUE | 1 |
| 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | GC | This service has been performed in part by a resident under the direction of a teaching physician | Q0 | Investigational clinical service provided in a clinical research study that is in an approved clinical research study |
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| 2014-01-01 | Added | Added |
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