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The procedure described by CPT® Code 0643T involves the implantation of a transcatheter left ventricular restoration device, which is specifically designed for patients suffering from heart failure. This innovative approach aims to enhance the efficiency of the heart's pumping action while simultaneously reducing the workload on the heart. The left ventricular restoration device works by decreasing the size and wall tension of the left ventricle (LV), which is crucial in cases where the heart's structure has been compromised due to conditions such as ischemic heart disease or dilated cardiomyopathy. Unlike traditional surgical methods for ventricular restoration, this transcatheter technique utilizes catheter-deployed anchors to effectively exclude scarred myocardial tissue from the LV, thereby restoring a more natural, conical shape to the heart chamber. Among the various percutaneous devices available, one notable example is the parachute device, which features a ventricular partition made from a self-expanding nitinol frame that resembles an umbrella. This device is equipped with 16 struts and anchors at each tip, all covered by a fluoropolymer membrane. The implantation procedure is typically performed in a catheterization laboratory under conscious sedation, utilizing imaging techniques such as fluoroscopy and transthoracic echocardiography for guidance. Access to the femoral artery is achieved through a puncture, allowing for the insertion of a sheath and the subsequent threading of a guidewire into the LV. The delivery catheter, pre-shaped for this purpose, is then navigated to the apex of the LV, where the parachute device is deployed to restore the heart's function effectively.
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The transcatheter left ventricular restoration device implantation is indicated for patients experiencing heart failure, particularly in cases where the left ventricle has become enlarged or has altered geometry due to myocardial scarring or dysfunction. This procedure is suitable for individuals who may benefit from a reduction in left ventricular volume and wall stress, thereby improving cardiac efficiency and overall function.
The procedure for transcatheter left ventricular restoration device implantation involves several critical steps to ensure successful placement and function of the device.
After the transcatheter left ventricular restoration device implantation, patients are typically monitored for any immediate complications related to the procedure. Post-procedure care may include observation in a recovery area, where vital signs are closely monitored. Patients may experience some discomfort at the access site, which should be managed appropriately. Follow-up imaging may be required to assess the position and function of the implanted device, and patients will be provided with specific instructions regarding activity restrictions and medication management to support recovery and optimize heart function.
| Short Descr | TCAT L VENTR RSTRJ DEV IMPLT | Medium Descr | TRANSCATHETER L VENTR RESTORATION DEVICE IMPLTJ | Long Descr | Transcatheter left ventricular restoration device implantation including right and left heart catheterization and left ventriculography when performed, arterial approach | 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) | 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 | Inpatient Procedures, not paid under OPPS | Berenson-Eggers TOS (BETOS) | none | MUE | 1 |
This is a primary code that can be used with these additional add-on codes.
| 33367 | Addon Code MPFS Status: Active Code APC C Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; cardiopulmonary bypass support with percutaneous peripheral arterial and venous cannulation (eg, femoral vessels) (List separately in addition to code for primary procedure) | 33368 | Addon Code MPFS Status: Active Code APC C Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; cardiopulmonary bypass support with open peripheral arterial and venous cannulation (eg, femoral, iliac, axillary vessels) (List separately in addition to code for primary procedure) | 33369 | Addon Code MPFS Status: Active Code APC C Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; cardiopulmonary bypass support with central arterial and venous cannulation (eg, aorta, right atrium, pulmonary artery) (List separately in addition to code for primary procedure) |
| Q0 | Investigational clinical service provided in a clinical research study that is in an approved clinical research study | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study |
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| 2022-01-01 | Added | First appearance in codebook. |
| 2021-07-01 | Added | Code added. |
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