CPT® Code 0675T

1. Indications

The procedure associated with CPT® Code 0675T is indicated for patients experiencing moderate to severe heart failure with preserved ventricular synchrony. This condition often results in a weakened heart that struggles to pump effectively, leading to inadequate blood flow and various complications. The synchronized diaphragmatic stimulation system aims to enhance cardiac function by improving the mechanics of the heart's filling and emptying processes through diaphragmatic stimulation.

• Moderate to Severe Heart Failure This condition is characterized by the heart's inability to pump sufficient blood to meet the body's needs, often resulting in symptoms such as fatigue, shortness of breath, and fluid retention.
• Preserved Ventricular Synchrony This refers to the maintenance of coordinated contractions of the heart's ventricles, which is crucial for effective cardiac function and overall hemodynamic stability.

2. Procedure

The laparoscopic insertion of a new or replacement diaphragmatic lead involves several key procedural steps that ensure the successful implantation of the synchronized diaphragmatic stimulation system.

• Step 1: Preparation The patient is positioned appropriately, and standard surgical preparations are performed, including anesthesia administration and sterilization of the surgical site to minimize the risk of infection.
• Step 2: Incision Creation Two small half-inch incisions are made in the abdominal area to facilitate access to the diaphragm. These incisions are strategically placed to allow for the insertion of the bipolar leads.
• Step 3: Lead Implantation The bipolar active fixation leads are carefully implanted on the underside of the diaphragm. This step requires precision to ensure that the leads are positioned correctly for optimal stimulation of the diaphragm.
• Step 4: Pulse Generator Placement A small subcutaneous pocket is created in the abdomen to house the implantable pulse generator. This device is crucial as it detects cardiac activity and sends electrical signals to the diaphragm leads.
• Step 5: Connection of Leads The implanted leads are then connected to the pulse generator. This connection is essential for the system to function, as it allows the pulse generator to deliver synchronized stimulation to the diaphragm.
• Step 6: Closure After ensuring that all components are securely in place and functioning correctly, the incisions are closed using appropriate suturing techniques, and the surgical site is dressed.

3. Post-Procedure

Following the laparoscopic insertion of the diaphragmatic lead, patients are typically monitored for any immediate complications related to the procedure. Post-procedure care may include pain management, monitoring for signs of infection, and ensuring that the device is functioning as intended. Patients may be advised on activity restrictions and follow-up appointments to assess the effectiveness of the stimulation system in improving cardiac function. Recovery time can vary, but many patients can expect to resume normal activities within a few weeks, depending on their overall health and the specifics of their surgical experience.