CPT® Code 0415T

1. Indications

The procedure associated with CPT® Code 0415T is indicated for patients who have a previously implanted cardiac contractility modulation (CCM) system that requires repositioning of the transvenous electrode. This may be necessary due to various factors, including:

• Electrode Malposition The electrode may have shifted from its optimal position, leading to suboptimal therapeutic effects.
• Device Dysfunction Issues with the electrode's function may necessitate repositioning to restore effective stimulation of the cardiac muscle.
• Patient Symptoms Patients may experience symptoms related to inadequate contractility modulation, prompting the need for repositioning.

2. Procedure

The procedure for repositioning a previously implanted cardiac contractility modulation transvenous electrode involves several critical steps:

• Step 1: Incision An incision is made in the skin to expose the pulse generator of the CCM system. This access is necessary to manipulate the electrode and ensure proper positioning.
• Step 2: Disconnection The transvenous electrode, which can be either an atrial or ventricular lead, is carefully disconnected from the pulse generator. This step is crucial to allow for the repositioning of the electrode without interference from the device.
• Step 3: Repositioning Under fluoroscopic guidance, the electrode is repositioned to an optimal location. Fluoroscopy provides real-time imaging, allowing the physician to accurately place the electrode for effective stimulation.
• Step 4: Reconnection Once the electrode is in the desired position, it is reconnected to the pulse generator. This step ensures that the electrode can once again deliver the necessary electrical impulses to the cardiac muscle.
• Step 5: Closure The incision made in the skin is then closed with sutures, completing the procedure. Proper closure is essential for minimizing the risk of infection and promoting healing.

3. Post-Procedure

After the repositioning procedure, patients may require monitoring to assess the effectiveness of the newly positioned electrode. Expected recovery includes observation for any signs of complications, such as infection or improper electrode function. Patients may also need follow-up appointments to evaluate the performance of the CCM system and ensure that the repositioned electrode is delivering the intended therapeutic effects. Instructions regarding activity restrictions and wound care will be provided to facilitate optimal recovery.