CPT® Code 0575T

Official Description

Programming device evaluation (in person) of implantable cardioverter-defibrillator system with substernal electrode, 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 by a physician or other qualified health care professional

Common Language Description

The CPT® Code 0575T refers to a specific procedure known as the programming device evaluation of an implantable cardioverter-defibrillator (ICD) system that includes a substernal electrode. This evaluation is conducted in person and involves a comprehensive assessment of the device's functionality. During this procedure, the healthcare professional performs iterative adjustments to the implantable device, which allows for testing its operational capabilities and selecting the optimal permanent programmed values. The process includes a thorough analysis, review, and documentation of findings by a physician or another qualified healthcare professional. The patient is typically connected to an electrocardiogram (EKG) monitor to facilitate real-time monitoring of cardiac rhythms. The evaluation encompasses a detailed interrogation of the device, where current stored data related to the patient's cardiac rhythm and any tachyarrhythmia episodes are reviewed and compared to previous data. This ensures that the device is functioning correctly and that any issues with leads, battery life, or pacing integrity are identified and addressed. Additionally, the procedure involves obtaining sensing threshold data from each cardiac chamber and evaluating for any cross-talk, which is when stimulation in one chamber inadvertently affects another. Atrial and ventricular stimulation tests are also performed to check for phrenic nerve stimulation. The iterative programming process is crucial for determining the best settings for the device, as it assesses the impact of changes on ventricular pacing, hemodynamics, and the heart's overall response. The healthcare professional reviews exercise and physiological stress data to observe heart rate adaptations, and any necessary reprogramming of the ICD system is conducted based on a careful evaluation of all parameters. Finally, the patient receives instructions regarding any follow-up services or procedures that may be required after the evaluation.

1. Indications

The procedure associated with CPT® Code 0575T is indicated for patients who have an implantable cardioverter-defibrillator (ICD) system with a substernal electrode. The following conditions may warrant this programming device evaluation:

Assessment of Device Functionality The procedure is performed to evaluate the operational status of the ICD, ensuring that it is functioning as intended.
Adjustment of Programming Parameters It is indicated when there is a need to adjust the programmed values of the device to optimize its performance based on the patient's specific cardiac needs.
Review of Cardiac Rhythm Data The evaluation is necessary for reviewing stored data related to the patient's cardiac rhythms and any episodes of tachyarrhythmia, which may require adjustments to the device settings.
Monitoring of Lead and Battery Integrity The procedure is indicated to assess the integrity of the leads and battery of the ICD, ensuring that there are no issues that could affect the device's performance.

2. Procedure

The programming device evaluation procedure involves several critical steps to ensure the proper functioning of the implantable cardioverter-defibrillator system:

Step 1: Patient Connection The patient is connected to an electrocardiogram (EKG) monitor to allow for continuous monitoring of cardiac rhythms throughout the evaluation process.
Step 2: Establishing Connection A connection is established between the ICD system and the programming device, enabling the healthcare professional to access the device's data and settings.
Step 3: Cardiac Rhythm Assessment The healthcare professional assesses the current cardiac rhythm, which is crucial for understanding the patient's heart function and any potential arrhythmias.
Step 4: Data Interrogation and Review Current stored data related to cardiac rhythm and tachyarrhythmia episodes is interrogated, reviewed, and compared with previous data acquisitions to identify any changes or issues.
Step 5: Device Function Assessment The function of the device is assessed, including the evaluation of leads and battery status, as well as addressing any pacing or integrity issues that may arise.
Step 6: Sensing Threshold Data Collection Sensing threshold data is obtained from each chamber of the heart to evaluate the device's sensitivity and response to cardiac signals.
Step 7: Cross-Talk Evaluation The procedure includes an evaluation for cross-talk, which occurs when stimulation of one chamber inadvertently activates another chamber, potentially affecting device performance.
Step 8: Atrial and Ventricular Stimulation Atrial and ventricular stimulation tests are performed to assess the presence or absence of phrenic nerve stimulation, which can impact the patient's heart function.
Step 9: Iterative Programming Process An iterative programming process is utilized to determine optimal settings, with adjustments made based on the effects on ventricular pacing, hemodynamics, and the heart's response to changes.
Step 10: Review of Exercise and Physiologic Stress Data The healthcare professional reviews any available exercise and physiological stress data to note heart rate adaptations and ensure the device settings are appropriate for the patient's activity levels.
Step 11: Reprogramming as Necessary After careful evaluation of all parameters, any necessary reprogramming of the ICD system is performed to optimize its performance.
Step 12: Patient Instructions Finally, the patient is provided with instructions regarding any required follow-up services or procedures that may be necessary after the evaluation.

3. Post-Procedure

After the programming device evaluation is completed, the patient may be monitored for a short period to ensure that the device is functioning correctly and that there are no immediate complications. The healthcare professional will provide the patient with detailed instructions regarding any follow-up appointments or additional procedures that may be necessary. It is important for the patient to adhere to these instructions to ensure ongoing monitoring and management of their implantable cardioverter-defibrillator system. The patient may also be advised to report any unusual symptoms or changes in their condition to their healthcare provider promptly.

Short Descr	PRGRMG DEV EVAL ICDS SS IP
Medium Descr	PROGRAMMING DEV EVAL ICDS W/SS ELTRD IN PERSON
Long Descr	Programming device evaluation (in person) of implantable cardioverter-defibrillator system with substernal electrode, 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 by a physician or other qualified health care professional
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)	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)	none
MUE	1