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The CPT® Code 0530T refers to the procedure for the removal of an intracardiac ischemia monitoring system, which includes all necessary imaging supervision and interpretation. This complete system consists of both the electrode and the implantable monitor. An intracardiac ischemia monitoring system is typically utilized in patients who have a history of acute coronary syndrome, such as myocardial infarction (MI) or unstable angina, and who are considered to be at high risk for experiencing recurrent cardiac events. The monitoring system is designed to detect significant ST segment changes in the electrocardiogram (EKG) that occur within a normal heart rate range, which can indicate ischemia related to supply issues, potentially due to thrombotic or vasospastic occlusion of the coronary arteries. The system features an EKG electrode that is strategically placed in the apex of the right ventricle, where it continuously senses ST segment changes. This data is transmitted to the implanted monitor, which is programmed to alert the patient through a vibration alarm, prompting them to seek emergency medical assistance if necessary. Additionally, an external alarm device is included to provide visual and auditory alerts to the patient. The procedure for implanting the EKG electrode involves gaining venous access, which can be achieved through standard percutaneous puncture of the subclavian vein or via a cut down technique to access the cephalic vein. Fluoroscopic guidance is employed to ensure accurate placement of the guidewire into the right ventricle, followed by the introduction of a vascular sheath. Once the electrode is optimally positioned and secured, a subcutaneous pocket is created for the monitor, which is then connected to the electrode and tested before being implanted. The removal procedure, as described by CPT® Code 0530T, involves making an incision over the implanted monitor to expose the device and electrode wire, followed by careful dissection to free the components from surrounding tissue. The electrode is disconnected from the monitor, and both the electrode and the monitor are removed under fluoroscopic guidance. This comprehensive description encapsulates the critical aspects of the procedure while adhering strictly to the provided CPT® data.
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The intracardiac ischemia monitoring system is indicated for patients with a prior history of acute coronary syndrome, which includes conditions such as myocardial infarction (MI) and unstable angina. These patients are typically at high risk for recurrent cardiac events, necessitating continuous monitoring of their cardiac status to detect any significant changes that may indicate ischemia.
The procedure for the removal of the intracardiac ischemia monitoring system involves several critical steps to ensure the safe extraction of both the electrode and the implantable monitor. Initially, an incision is made over the implanted monitor, allowing access to the device and the EKG electrode wire. This incision is carefully carried down to expose the components, which are then meticulously dissected free from the surrounding tissue to prevent any damage. Once the electrode is accessible, it is disconnected from the monitor, ensuring that the connection is cleanly severed to facilitate the removal process. Following this, the EKG electrode is pulled back through the heart and blood vessel under fluoroscopic guidance, which provides real-time imaging to ensure proper navigation and minimize complications. This step is crucial as it allows for the safe extraction of the electrode from its position in the right ventricle. The complete removal of the monitoring system is reported using CPT® Code 0530T, which encompasses the entire procedure, including the imaging supervision and interpretation required throughout the process.
Post-procedure care following the removal of the intracardiac ischemia monitoring system typically involves monitoring the patient for any immediate complications related to the incision site and the removal of the device. Patients may be observed for signs of infection, bleeding, or any adverse reactions. Recovery expectations will vary based on individual patient factors, but generally, patients are advised to follow up with their healthcare provider to ensure proper healing and to discuss any further management of their cardiac health. Additional considerations may include instructions on activity restrictions and wound care to promote optimal recovery.
| Short Descr | REMOVAL COMPLETE IIMS | Medium Descr | REMOVAL COMPLETE IIMS INCL IMG S&I | Long Descr | Removal of intracardiac ischemia monitoring system, including all imaging supervision and interpretation; complete system (electrode and implantable monitor) | 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) | 2 - Standard 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) | 1 - Statutory 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 | T-Packaged Codes | ASC Payment Indicator | Non office-based surgical procedure added in CY 2008 or later; payment based on OPPS relative payment weight. | Berenson-Eggers TOS (BETOS) | none | MUE | 1 |
| XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| 2019-01-01 | Added | Added |
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