CPT® Code 0804T

Official Description

Programming device evaluation (in person) with iterative adjustment of implantable device to test the function of device and to select optimal permanent programmed values, with analysis, review, and report, by a physician or other qualified health care professional, leadless pacemaker system in dual cardiac chambers

Common Language Description

The procedure described by CPT® Code 0804T involves the in-person programming and evaluation of a leadless pacemaker system that operates in dual cardiac chambers. This process is essential for ensuring that the implanted device functions correctly and meets the specific needs of the patient. During the evaluation, a qualified healthcare professional, such as a physician, conducts a thorough interrogation of the device to assess its performance. This includes retrieving stored data to evaluate critical parameters such as battery function, signal sensing, and the communication between the atrial and ventricular components of the pacemaker. The healthcare professional will also analyze pacing capture thresholds and impedance to ensure optimal device operation. If the device's functioning is found to be inadequate or if the patient exhibits symptoms that suggest the need for adjustments, further testing and programming may be necessary. The ultimate goal of this procedure is to adjust and permanently program the device settings, including sensing values, rate response, voltage, pulse duration, and heart rate limits, to effectively manage the patient's heart rhythm and improve their overall cardiac health.

1. Indications

The procedure associated with CPT® Code 0804T is indicated for patients who have a leadless pacemaker system implanted in dual cardiac chambers. The specific indications for performing this procedure include:

Device Functionality Concerns When there are suspicions regarding the proper functioning of the implanted device, an evaluation is necessary to ensure it is operating as intended.
Patient Symptoms If the patient experiences symptoms that suggest the current device settings are ineffective, further programming may be required to optimize the device's performance.

2. Procedure

The procedure for CPT® Code 0804T involves several critical steps to ensure the effective evaluation and programming of the leadless pacemaker system. Each step is designed to assess and adjust the device's functionality as needed.

Step 1: In-Person Evaluation The healthcare professional conducts an in-person evaluation of the patient with the implanted leadless pacemaker. This allows for direct interaction and assessment of the device's performance in real-time.
Step 2: Device Interrogation The professional retrieves stored data from the pacemaker, which includes information on battery status, signal sensing, and communication between the atrial and ventricular components. This interrogation is crucial for understanding how the device is functioning.
Step 3: Performance Assessment The healthcare professional evaluates the performance of the pacemaker system by analyzing parameters such as pacing capture threshold and impedance. This assessment helps determine if the device is meeting the necessary operational standards.
Step 4: Parameter Adjustment Based on the findings from the interrogation and performance assessment, the healthcare professional may adjust various settings of the device. This includes modifying sensing values, rate response, voltage, pulse duration, and upper and lower heart rates to optimize the device's function.
Step 5: Permanent Programming After adjustments are made, the new settings are permanently programmed into the device. This ensures that the pacemaker operates effectively according to the patient's current cardiac needs.

3. Post-Procedure

Following the procedure, the patient may be monitored for any immediate reactions to the adjustments made to the pacemaker settings. It is essential to ensure that the device is functioning correctly and that the patient is experiencing improved heart rhythm management. The healthcare professional may provide instructions regarding follow-up appointments to reassess the device's performance and make any further adjustments if necessary. Additionally, the patient should be educated on recognizing any symptoms that may indicate issues with the pacemaker, ensuring they are aware of when to seek further medical attention.

Short Descr	PRGRMG EVL LDLS PM 2CHMBR IP
Medium Descr	PRGRMG DEV EVAL LDLS PM SYS 2CHMBR IN PERSON
Long Descr	Programming device evaluation (in person) with iterative adjustment of implantable device to test the function of device and to select optimal permanent programmed values, with analysis, review, and report, by a physician or other qualified health care professional, leadless pacemaker system in dual cardiac chambers
Status Code	Carriers Price the Code
Global Days	XXX - Global Concept Does Not Apply
PC/TC Indicator (26, TC)	1 - Diagnostic Tests for Radiology Services
Multiple Procedures (51)	6 - Special payment adjustment rules on the technical component (TC) of multiple diagnostic cardiovascular services 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

26	Professional component: certain procedures are a combination of a physician or other qualified health care professional component and a technical component. when the physician or other qualified health care professional component is reported separately, the service may be identified by adding modifier 26 to the usual procedure number.
Q0	Investigational clinical service provided in a clinical research study that is in an approved clinical research study
XU	Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service