How To Use CPT Code 0269T

CPT 0269T describes the revision or removal of a carotid sinus baroreflex activation device, which includes the placement of a generator, lead placement, 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 0269T?

CPT 0269T is used to report the revision or removal of a carotid sinus baroreflex activation device. This device consists of leads and a pulse generator that are placed in the carotid sinus to help lower the heart rate and blood pressure of the patient by stimulating the baroreceptors in the carotid arteries. The procedure involves making incisions near the clavicle on each side of the neck to access the carotid sinus, identifying the electrodes and wires, and revising or removing the device as needed.

2. Official Description

The official description of CPT code 0269T is: ‘Revision or removal of carotid sinus baroreflex activation device; total system (includes generator placement, unilateral or bilateral lead placement, intra-operative interrogation, programming, and repositioning, when performed).’ It is important to note that CPT code 0269T should not be reported in conjunction with codes 0266T-0268T and 0270T-0273T.

3. Procedure

1. The provider prepares the patient and administers anesthesia.
2. An incision is made near the clavicle on each side of the neck to access the carotid sinus.
3. The provider identifies the electrodes in the carotid sinus, attached wires, and pulse generator placed subcutaneously beneath the skin.
4. The provider revises or removes the device as necessary.
5. If revising the device, the provider tests the system for accuracy.
6. The pulse generator stimulates the electrodes to activate the baroreceptors in the carotid sinus, resulting in dilation of the vessels and a reduction in heart rate and blood pressure.
7. Hemostasis is achieved, and the incisions are closed in layers.

4. Qualifying circumstances

CPT code 0269T is used for patients with resistant hypertension, which is an increase in blood pressure despite treatment with at least three antihypertensive drugs. The device is placed in the carotid sinus, an area in the neck that contains baroreceptors responsible for reducing blood pressure upon activation. The procedure is performed by a provider who is qualified to perform the revision or removal of the device, and it may involve the placement of unilateral or bilateral leads and a pulse generator.

5. When to use CPT code 0269T

CPT code 0269T should be used when the provider performs the revision or removal of a carotid sinus baroreflex activation device, including the placement of a generator, unilateral or bilateral lead placement, intra-operative interrogation, programming, and repositioning if necessary. It should not be reported in conjunction with codes 0266T-0268T and 0270T-0273T.

6. Documentation requirements

To support a claim for CPT code 0269T, the provider must document the following information:

• Patient’s diagnosis of resistant hypertension
• Description of the device being revised or removed
• Date of the procedure
• Start and end time of the procedure
• Details of the procedure, including the placement of leads and generator, intra-operative interrogation, programming, and repositioning if performed
• Any complications or unexpected findings
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT code 0269T, ensure that the procedure meets the requirements outlined in the official description. It is important to note that CPT code 0269T should not be reported in conjunction with codes 0266T-0268T and 0270T-0273T. If the provider revises or removes only unilateral leads, use code 0270T. If the provider revises or removes only the pulse generator, use code 0271T.

8. Historical information

CPT code 0269T was added to the Current Procedural Terminology system on January 1, 2012. There have been no updates to the code since its addition.

9. Examples

1. A provider revises a carotid sinus baroreflex activation device, including the placement of a generator, bilateral lead placement, intra-operative interrogation, programming, and repositioning if necessary, for a patient with resistant hypertension.
2. A provider removes a carotid sinus baroreflex activation device, including the removal of bilateral leads and the pulse generator, for a patient who no longer requires the device.
3. A provider revises a carotid sinus baroreflex activation device, including the placement of a generator and unilateral lead placement, for a patient with resistant hypertension.
4. A provider removes a carotid sinus baroreflex activation device, including the removal of a unilateral lead and the pulse generator, for a patient who experienced complications with the device.
5. A provider revises a carotid sinus baroreflex activation device, including the placement of a generator and bilateral lead placement, for a patient with resistant hypertension.
6. A provider removes a carotid sinus baroreflex activation device, including the removal of bilateral leads and the pulse generator, for a patient who wishes to discontinue the use of the device.
7. A provider revises a carotid sinus baroreflex activation device, including the placement of a generator and unilateral lead placement, for a patient with resistant hypertension.
8. A provider removes a carotid sinus baroreflex activation device, including the removal of a unilateral lead and the pulse generator, for a patient who has achieved adequate blood pressure control through other means.
9. A provider revises a carotid sinus baroreflex activation device, including the placement of a generator and bilateral lead placement, for a patient with resistant hypertension.
10. A provider removes a carotid sinus baroreflex activation device, including the removal of bilateral leads and the pulse generator, for a patient who is no longer responsive to the device.