How To Use CPT Code 0266T

CPT 0266T describes the implantation or replacement of a carotid sinus baroreflex activation device, which includes the placement of a generator, leads, intra-operative interrogation, programming, and repositioning if necessary. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples.

1. What is CPT Code 0266T?

CPT 0266T is used to describe the implantation or replacement of a carotid sinus baroreflex activation device. This device consists of a pulse generator and leads that are placed in the carotid sinus to stimulate the baroreceptors, which helps to lower the heart rate and blood pressure of the patient. The procedure may also include intra-operative interrogation, programming, and repositioning if necessary.

2. Official Description

The official description of CPT code 0266T is: ‘Implantation or replacement of carotid sinus baroreflex activation device; total system (includes generator placement, unilateral or bilateral lead placement, intra-operative interrogation, programming, and repositioning, when performed).’

3. Procedure

1. The provider begins by making incisions near the clavicle on each side of the neck to access the carotid sinus.
2. Electrodes are then placed in the carotid sinus and connected to wires.
3. The wires are then connected to the pulse generator, which is placed subcutaneously beneath the skin.
4. The system is tested for accuracy to ensure proper stimulation of the baroreceptors.
5. If necessary, the provider may reposition the leads or make adjustments to the programming of the device.
6. Hemostasis is achieved to stop any bleeding, and the incisions are closed in layers.

4. Qualifying circumstances

CPT 0266T is performed on patients with resistant hypertension, which is an increase in blood pressure despite treatment with at least three antihypertensive drugs. The device is implanted or replaced by a qualified healthcare provider and may involve the placement of unilateral or bilateral leads, depending on the patient’s condition. The procedure is performed to activate the baroreceptors in the carotid sinus and reduce blood pressure.

5. When to use CPT code 0266T

CPT code 0266T should be used when a provider performs the implantation or replacement of a carotid sinus baroreflex activation device, including the placement of a generator and leads, intra-operative interrogation, programming, and repositioning if necessary. This code should not be used if only unilateral leads or the pulse generator are implanted or replaced, as separate codes exist for those procedures.

6. Documentation requirements

To support a claim for CPT code 0266T, the provider must document the following information:

• Patient’s diagnosis of resistant hypertension
• Details of the procedure, including the placement of the generator and leads
• Intra-operative interrogation and programming, if performed
• Any repositioning or adjustments made during the procedure
• Date of the procedure and the duration of the surgery
• Signature of the qualified healthcare provider

7. Billing guidelines

When billing for CPT code 0266T, ensure that the procedure includes the implantation or replacement of the total system, including the generator, leads, intra-operative interrogation, programming, and repositioning if necessary. It is important to note that CPT code 0266T should not be reported if only unilateral leads or the pulse generator are implanted or replaced. Additional codes exist for those specific procedures. It is also important to follow any specific billing guidelines provided by insurance payers or Medicare.

8. Historical information

CPT code 0266T was added to the Current Procedural Terminology system on January 1, 2012. It was initially listed as an Inpatient Only (IPO) procedure but was later removed from the IPO list in 2019.

9. Examples

1. A provider implants a carotid sinus baroreflex activation device, including the placement of a generator, bilateral leads, intra-operative interrogation, programming, and repositioning if necessary, for a patient with resistant hypertension.
2. During a surgical procedure, a provider replaces a carotid sinus baroreflex activation device, including the placement of a generator, unilateral leads, intra-operative interrogation, programming, and repositioning if necessary, for a patient with resistant hypertension.
3. A qualified healthcare provider performs the implantation of a carotid sinus baroreflex activation device, including the placement of a generator, bilateral leads, intra-operative interrogation, programming, and repositioning if necessary, for a patient with resistant hypertension.
4. For a patient with resistant hypertension, a provider replaces a carotid sinus baroreflex activation device, including the placement of a generator, bilateral leads, intra-operative interrogation, programming, and repositioning if necessary, during a surgical procedure.
5. A provider performs the implantation of a carotid sinus baroreflex activation device, including the placement of a generator, unilateral leads, intra-operative interrogation, programming, and repositioning if necessary, for a patient with resistant hypertension.
6. During a surgical procedure, a qualified healthcare provider replaces a carotid sinus baroreflex activation device, including the placement of a generator, bilateral leads, intra-operative interrogation, programming, and repositioning if necessary, for a patient with resistant hypertension.
7. A provider implants a carotid sinus baroreflex activation device, including the placement of a generator, unilateral leads, intra-operative interrogation, programming, and repositioning if necessary, for a patient with resistant hypertension.
8. For a patient with resistant hypertension, a qualified healthcare provider replaces a carotid sinus baroreflex activation device, including the placement of a generator, unilateral leads, intra-operative interrogation, programming, and repositioning if necessary, during a surgical procedure.
9. A provider performs the implantation of a carotid sinus baroreflex activation device, including the placement of a generator, bilateral leads, intra-operative interrogation, programming, and repositioning if necessary, for a patient with resistant hypertension.
10. During a surgical procedure, a qualified healthcare provider replaces a carotid sinus baroreflex activation device, including the placement of a generator, bilateral leads, intra-operative interrogation, programming, and repositioning if necessary, for a patient with resistant hypertension.