CPT® Code 0389T | Case2Code

Code deleted, see 33274, 33275, 93279, 93286, 93288, 93294, 93296

Official Description

Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report, leadless pacemaker system

Common Language Description

The procedure described by CPT® Code 0389T involves the in-person programming device evaluation of a leadless pacemaker system. This evaluation is crucial for assessing the functionality of the implantable device and involves iterative adjustments to ensure optimal performance. During this evaluation, the clinician reviews various stored and measured data from the pacemaker, which includes critical parameters such as battery life, capture and sensing functions, and heart rhythms. The evaluation process may also encompass an analysis of sensor responses, rate responses, upper and lower heart rates, atrioventricular (AV) intervals, pacing voltage, and pulse duration. To facilitate this assessment, electrocardiogram (ECG) electrodes are placed on the patient's chest and extremities, allowing for accurate monitoring and data collection. These electrodes are connected to a computer equipped with specialized software that downloads information from the pacemaker, presenting it on a display screen or in a printed format. The clinician then reviews the current functioning of the device, makes necessary adjustments, analyzes the programmed parameters, selects the optimal permanent settings, and generates a comprehensive written report detailing the findings and adjustments made during the evaluation of the leadless pacemaker system.

1. Indications

The programming device evaluation for a leadless pacemaker system is indicated for patients who require ongoing monitoring and adjustment of their implantable device. This procedure is performed to ensure the device is functioning correctly and to optimize its settings for effective cardiac pacing. The specific indications include:

Device Functionality Assessment Evaluation of the leadless pacemaker's performance, including battery life and heart rhythm monitoring.
Parameter Adjustment Adjustment of programmed parameters such as pacing voltage, pulse duration, and rate response to meet the patient's needs.
Monitoring Heart Rhythms Continuous assessment of the patient's heart rhythms to ensure appropriate pacing and capture.

2. Procedure

The procedure for programming device evaluation of a leadless pacemaker system involves several key steps that ensure comprehensive assessment and adjustment of the device. These steps include:

Step 1: Patient Preparation The patient is prepared for the evaluation by placing electrocardiogram (ECG) electrodes on the chest and extremities. This setup is essential for accurate monitoring of the heart's electrical activity during the evaluation.
Step 2: Data Downloading The electrodes are connected to a computer that utilizes specialized software to download information from the leadless pacemaker. This data includes stored measurements and parameter settings that are critical for the evaluation process.
Step 3: Data Review The clinician reviews the downloaded information, which encompasses various aspects of the device's performance, including battery life, capture and sensing functions, and heart rhythms. This review is crucial for identifying any necessary adjustments.
Step 4: Iterative Adjustments Based on the review, the clinician makes iterative adjustments to the device settings. This may involve modifying parameters such as pacing voltage, pulse duration, and rate response to optimize the device's performance for the patient.
Step 5: Reporting After completing the evaluation and adjustments, the clinician generates a written report that details the findings, adjustments made, and the optimal permanent settings selected for the leadless pacemaker system.

3. Post-Procedure

Post-procedure care following the programming device evaluation of a leadless pacemaker system typically involves monitoring the patient for any immediate reactions to the adjustments made. The clinician may provide instructions regarding follow-up appointments to ensure ongoing assessment of the device's performance. Additionally, the patient may be advised on signs and symptoms to watch for that could indicate issues with the pacemaker, such as changes in heart rhythm or unusual sensations. Regular follow-up evaluations are essential to maintain optimal device function and patient safety.

Short Descr	PROG EVAL INPER LEADLS PM
Medium Descr	PROG DEVICE EVAL IN PERSON LEADLESS PM SYSTEM
Long Descr	Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report, leadless pacemaker system
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	STV-Packaged Codes
Berenson-Eggers TOS (BETOS)	I4A - Imaging/procedure - heart including cardiac catheter
MUE	Not applicable/unspecified.