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The procedure described by CPT® Code 0676T involves the laparoscopic insertion of new or replacement diaphragmatic lead(s) as part of a permanent implantable synchronized diaphragmatic stimulation (SDS) system. This system is specifically designed to augment cardiac function, particularly in patients suffering from moderate to severe heart failure while maintaining preserved ventricular synchrony. The primary goal of this procedure is to enhance the heart's ability to pump blood more effectively, thereby improving overall blood flow without placing additional stress on the heart muscle. The SDS system operates by stimulating the diaphragm in synchronization with the cardiac cycle, which modifies chest pressure and facilitates better filling and emptying of the heart. The device itself comprises an implantable pulse generator, bipolar active fixation leads, and programming software. During the laparoscopic procedure, two small incisions, each approximately half an inch in length, are made to allow for the implantation of the bipolar leads on the underside of the diaphragm. Additionally, a small subcutaneous pocket is created in the abdominal area to accommodate the pulse generator, which is responsible for detecting cardiac activity. The leads are then connected to this pulse generator, which delivers a small electrical shock to stimulate a specific area of the diaphragm, ensuring that normal breathing is not affected. It is important to note that this code is used for reporting the placement of the second or any additional lead, while other codes are designated for the implantation or complete replacement of the entire system or for the first lead placement. This structured approach ensures that the procedure is accurately documented and billed, reflecting the complexity and specificity of the intervention performed.
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The laparoscopic insertion of new or replacement diaphragmatic lead(s) is indicated for patients with moderate to severe heart failure who have preserved ventricular synchrony. This procedure is particularly beneficial for individuals whose cardiac function can be augmented through synchronized diaphragmatic stimulation, thereby improving their overall cardiac output and quality of life.
The procedure begins with the patient being placed under general anesthesia to ensure comfort and immobility during the laparoscopic intervention. Following anesthesia, the surgeon makes two small incisions, each approximately half an inch in length, in the abdominal area. These incisions provide access to the diaphragm, where the bipolar leads will be implanted. The surgeon carefully positions the bipolar active fixation leads on the underside of the diaphragm, ensuring they are securely attached to facilitate effective stimulation.
After the procedure, patients are typically monitored in a recovery area until the effects of anesthesia wear off. Post-operative care may include pain management and monitoring for any signs of complications, such as infection or lead displacement. Patients are usually advised on activity restrictions and follow-up appointments to assess the functionality of the implanted system. The expected recovery time can vary, but many patients can resume normal activities within a few weeks, depending on their overall health and the specifics of the procedure performed.
| Short Descr | LAPS INSJ NW/RPCMT ISDSS EA | Medium Descr | LAPS INSJ NEW/RPLCMT LEAD PERM ISDSS EA ADL LEAD | Long Descr | Laparoscopic insertion of new or replacement of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; each additional lead (List separately in addition to code for primary procedure) | Status Code | Carriers Price the Code | Global Days | ZZZ - Code Related to Another Service | 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) | 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 | Items and Services Packaged into APC Rates | ASC Payment Indicator | Packaged service/item; no separate payment made. | Berenson-Eggers TOS (BETOS) | none | MUE | 1 |
This is an add-on code that must be used in conjunction with one of these primary codes.
| 0675T | MPFS Status: Carrier Priced APC J1 ASC J8 Laparoscopic insertion of new or replacement of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; first lead |
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| 2022-01-01 | Added | Code added |
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