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An extracorporeal ventricular assist device (VAD) is a sophisticated medical apparatus designed to support heart function in patients with severe heart failure. This device comprises a mechanical pump, a control system, and an energy supply, all of which work in concert to assist the heart in circulating blood throughout the body. The term "extracorporeal" indicates that the device operates outside the body, utilizing pumps that are not implanted but rather connected to the heart via an inflow cannula and an outflow graft. The need for replacement of the pump may arise due to mechanical failure, which can compromise the device's ability to function effectively. During the replacement procedure, the existing pump is carefully disconnected from its power source, the battery pack, as well as from the inflow cannula and outflow graft. A new pump is then introduced, ensuring it is properly connected to the inflow cannula and outflow graft, allowing it to fill with blood before being reconnected to the battery pack. This process is critical for maintaining the patient's hemodynamic stability and overall health.
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The replacement of an extracorporeal ventricular assist device (VAD) is indicated in specific clinical scenarios where the existing pump has failed or is no longer functioning optimally. The following conditions may warrant this procedure:
The procedure for replacing an extracorporeal ventricular assist device involves several critical steps to ensure the safe and effective transition from the old pump to the new one. Each step is essential for maintaining the patient's hemodynamic stability throughout the process.
Post-procedure care following the replacement of an extracorporeal ventricular assist device is critical for ensuring patient safety and optimal recovery. Patients are typically monitored closely for any signs of complications, such as bleeding or infection at the connection sites. Additionally, the function of the new pump is continuously assessed to ensure it is operating as intended. Patients may require adjustments in their medication regimen to support their cardiovascular health during the recovery phase. Regular follow-up appointments are essential to evaluate the performance of the new pump and to make any necessary modifications to the patient's treatment plan.
| Short Descr | REPLACE VAD PUMP EXT | Medium Descr | RPLCMT XTRCORP VAD 1/BIVENTR PUMP 1/EA PUMP | Long Descr | Replacement of extracorporeal ventricular assist device, single or biventricular, pump(s), single or each pump | Status Code | Active Code | Global Days | XXX - Global Concept Does Not Apply | 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) | 2 - Payment restriction for assistants at surgery does not apply 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 | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P2F - Major procedure, cardiovascular-Other | MUE | 1 | CCS Clinical Classification | 49 - Other OR heart procedures |
This is a primary code that can be used with these additional add-on codes.
| 33257 | Addon Code MPFS Status: Active Code APC C Illustration for Code Operative tissue ablation and reconstruction of atria, performed at the time of other cardiac procedure(s), limited (eg, modified maze procedure) (List separately in addition to code for primary procedure) | 33258 | Addon Code MPFS Status: Active Code APC C Illustration for Code Operative tissue ablation and reconstruction of atria, performed at the time of other cardiac procedure(s), extensive (eg, maze procedure), without cardiopulmonary bypass (List separately in addition to code for primary procedure) |
| 52 | Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 78 | Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.) | 82 | Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s). |
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| 2010-01-01 | Added | - |
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