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A laparoscopic repositioning of diaphragmatic lead(s) involves the surgical adjustment of a permanent implantable synchronized diaphragmatic stimulation (SDS) system, which is designed to enhance cardiac function. This procedure is particularly relevant for patients suffering from moderate to severe heart failure, where the heart's ability to pump blood is compromised, yet ventricular synchrony is preserved. The SDS system works by stimulating the diaphragm in coordination with the heart's rhythm, which helps to modify chest pressure. This modification facilitates improved filling and emptying of the heart, ultimately enhancing blood flow without placing additional stress on the heart muscle itself. The system comprises two bipolar active fixation leads that are implanted on the underside of the diaphragm, a pulse generator that detects cardiac activity, and programming software to manage the device's functions. The laparoscopic approach utilized in this procedure involves making two small incisions, approximately half an inch in length, through which the leads are implanted. Additionally, a subcutaneous pocket is created in the abdomen to accommodate the pulse generator. The repositioning of the lead may be necessary due to various factors such as movement, malpositioning, infection, hematoma, or discomfort at the original site. The procedure ensures that the lead is correctly positioned against the diaphragm, and if any complications such as hematoma or infection are present, appropriate measures are taken to address them. This minimally invasive technique allows for effective management of the SDS system, contributing to improved cardiac function in patients with heart failure.
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The laparoscopic repositioning of diaphragmatic lead(s) is indicated for patients experiencing issues related to the existing implanted synchronized diaphragmatic stimulation (SDS) system. The specific indications include:
The procedure for laparoscopic repositioning of diaphragmatic lead(s) involves several key steps:
Post-procedure care involves monitoring the patient for any immediate complications, such as infection or excessive bleeding. Patients may be advised to rest and avoid strenuous activities for a specified period to facilitate healing. Follow-up appointments are typically scheduled to assess the functionality of the repositioned lead and the overall performance of the synchronized diaphragmatic stimulation system. Any concerns regarding pain or discomfort at the incision sites should be addressed promptly to ensure a smooth recovery process.
| Short Descr | LAPS REPOS LEAD ISDSS 1ST LD | Medium Descr | LAPS REPOS LEAD PERM ISDSS 1ST REPOSITIONED LEAD | Long Descr | Laparoscopic repositioning of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; first repositioned lead | 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 | Hospital Part B services paid through a comprehensive APC | ASC Payment Indicator | Device-intensive procedure added to ASC list in CY 2008 or later; paid at adjusted rate. | Berenson-Eggers TOS (BETOS) | none | MUE | 1 |
This is a primary code that can be used with these additional add-on codes.
| 0678T | Add-on Code MPFS Status: Carrier Priced APC N ASC N1 Laparoscopic repositioning of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; each additional repositioned lead (List separately in addition to code for primary procedure) |
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| 2022-01-01 | Added | Code added |
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