How To Use CPT Code 0338T

CPT 0338T describes a percutaneous approach to deliver radiofrequency energy to the endoluminal surface of the renal artery on one side of the body. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples.

1. What is CPT Code 0338T?

CPT 0338T can be used to describe a percutaneous approach that delivers radiofrequency energy to the endoluminal surface of the renal artery on one side of the body. This code is used when the physician performs an ablation procedure using radiofrequency energy to treat a specific condition in the renal artery.

2. Official Description

The official description of CPT code 0338T is: ‘Transcatheter renal sympathetic denervation, percutaneous approach including arterial puncture, selective catheter placement(s) renal artery(ies), fluoroscopy, contrast injection(s), intraprocedural roadmapping and radiological supervision and interpretation, including pressure gradient measurements, flush aortogram and diagnostic renal angiography when performed; unilateral.’

3. Procedure

1. The physician prepares the patient for the procedure and makes a small puncture to access the renal artery.
2. A catheter is maneuvered through the access vessel to the aorta, and the physician images the renal arteries using fluoroscopy.
3. A guiding catheter is used to access a specific renal artery, and an ablation catheter is delivered to that renal artery.
4. The physician delivers radiofrequency energy through the ablation catheter to perform the ablation procedure.
5. After the procedure, the catheters are removed, and any bleeding at the access site is stopped.

4. Qualifying circumstances

Patients eligible to receive CPT 0338T services are those who require a percutaneous approach to deliver radiofrequency energy to the endoluminal surface of the renal artery on one side of the body. This procedure is typically performed to treat specific conditions in the renal artery, such as renal sympathetic denervation. The physician must perform arterial puncture, selective catheter placement(s) in the renal artery(ies), and other necessary steps as described in the official description of the code.

5. When to use CPT code 0338T

CPT code 0338T should be used when the physician performs a percutaneous approach to deliver radiofrequency energy to the endoluminal surface of the renal artery on one side of the body. This code is specific to a unilateral procedure, meaning it is performed on one side of the body. If the procedure is performed bilaterally, a different code should be used.

6. Documentation requirements

To support a claim for CPT 0338T, the physician must document the following information:

• Patient’s diagnosis and the medical necessity of the procedure
• Details of the percutaneous approach, including arterial puncture and selective catheter placement in the renal artery
• Date and duration of the procedure
• Fluoroscopy, contrast injection, and other imaging techniques used
• Pressure gradient measurements, flush aortogram, and diagnostic renal angiography if performed
• Any complications or adverse events encountered during the procedure
• Signature of the performing physician

7. Billing guidelines

When billing for CPT 0338T, ensure that the procedure meets the criteria described in the official description. The physician should perform arterial puncture, selective catheter placement(s) in the renal artery(ies), and other necessary steps. It is important to follow the specific guidelines for reporting this code, including the use of modifiers if applicable. Additionally, consider any relevant bundling or unbundling rules and ensure accurate documentation to support the claim.

8. Historical information

CPT 0338T was added to the Current Procedural Terminology system on January 1, 2014. There have been no updates to the code since its addition.

9. Examples

1. A physician performing a percutaneous renal sympathetic denervation procedure using radiofrequency energy to treat hypertension in a patient.
2. A cardiologist delivering radiofrequency energy to the endoluminal surface of the renal artery to treat renal artery stenosis in a patient.
3. An interventional radiologist performing a percutaneous ablation procedure in the renal artery to treat renal cell carcinoma in a patient.
4. A vascular surgeon using a percutaneous approach to deliver radiofrequency energy to the renal artery to treat fibromuscular dysplasia in a patient.
5. An interventional nephrologist performing a renal sympathetic denervation procedure using radiofrequency energy to manage resistant hypertension in a patient.
6. A urologist delivering radiofrequency energy to the renal artery to treat renal artery aneurysm in a patient.
7. An interventional radiologist performing a percutaneous ablation procedure in the renal artery to treat renal artery thrombosis in a patient.
8. A vascular surgeon using a percutaneous approach to deliver radiofrequency energy to the renal artery to treat renal artery dissection in a patient.
9. An interventional nephrologist performing a renal sympathetic denervation procedure using radiofrequency energy to manage renal artery fibromuscular dysplasia in a patient.
10. A cardiologist delivering radiofrequency energy to the endoluminal surface of the renal artery to treat renal artery restenosis in a patient.