How To Use CPT Code 0412T

CPT 0412T describes the removal of a permanent cardiac contractility modulation (CCM) pulse generator from a previously created pocket in the right upper chest. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples.

1. What is CPT Code 0412T?

CPT 0412T can be used to describe the removal of a permanent cardiac contractility modulation (CCM) pulse generator. This code is specifically for the removal of the pulse generator only, not the entire CCM system. The procedure involves making an incision over the pulse generator in the right upper chest region, removing the pulse generator, checking for bleeding, and closing the incision(s).

2. Official Description

The official description of CPT code 0412T is: ‘Removal of permanent cardiac contractility modulation system; pulse generator only.’

3. Procedure

1. The provider makes an incision over the pulse generator previously placed in the right upper chest region.
2. The pulse generator is removed, and the provider checks for bleeding.
3. The incision(s) are closed.

4. Qualifying circumstances

CPT 0412T is used when a permanent cardiac contractility modulation (CCM) pulse generator needs to be removed. This procedure is typically performed on patients with moderate-to-severe congestive heart failure who have not responded to optimal medical therapy. It is important to note that this code is only for the removal of the pulse generator, not the entire CCM system.

5. When to use CPT code 0412T

CPT code 0412T should be used when the provider is removing a permanent cardiac contractility modulation (CCM) pulse generator. This code is specifically for the removal of the pulse generator only, not the entire CCM system. If the provider is removing both the pulse generator and all three leads, CPT code 0412T should be reported along with CPT code 0413T for each electrode removed.

6. Documentation requirements

To support a claim for CPT code 0412T, the provider must document the following information:

• Reason for the removal of the pulse generator
• Date of the procedure
• Details of the procedure, including the incision site and closure method
• Any complications or additional procedures performed
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT code 0412T, ensure that the procedure involves the removal of a permanent cardiac contractility modulation (CCM) pulse generator. This code should not be reported if the entire CCM system is being removed or replaced. If the provider is removing and replacing only the pulse generator, CPT code 0414T should be used. It is important to check with the payer regarding their policies on coverage for the CCM system, as it may be considered investigational by some payers.

8. Historical information

CPT code 0412T was added to the Current Procedural Terminology system on January 1, 2016. There have been no updates to the code since its addition.

9. Examples

1. A cardiologist removes a permanent cardiac contractility modulation (CCM) pulse generator from a patient with congestive heart failure.
2. An electrophysiologist performs the removal of a CCM pulse generator for a patient who has not responded to optimal medical therapy.
3. A cardiac surgeon removes a pulse generator from a patient’s right upper chest pocket as part of a CCM system removal procedure.
4. A cardiovascular technologist assists in the removal of a CCM pulse generator under the supervision of a physician.
5. A cardiac nurse documents the details of a CCM pulse generator removal procedure performed by a cardiologist.
6. A healthcare facility bills for the removal of a CCM pulse generator using CPT code 0412T.
7. A patient undergoes the removal of a CCM pulse generator as part of their treatment for congestive heart failure.
8. A medical coder accurately assigns CPT code 0412T for the removal of a permanent cardiac contractility modulation (CCM) pulse generator.
9. A healthcare provider discusses the risks and benefits of CCM pulse generator removal with a patient prior to the procedure.
10. A patient’s medical record includes documentation of the removal of a CCM pulse generator using CPT code 0412T.