How To Use CPT Code 0428T

CPT 0428T describes the removal of the pulse generator of a neurostimulator system used to treat central sleep apnea. This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples.

1. What is CPT Code 0428T?

CPT 0428T can be used to describe the removal of the pulse generator of a neurostimulator system used for the treatment of central sleep apnea. This code is specifically used when only the pulse generator is being removed, and not the entire system.

2. Official Description

The official description of CPT code 0428T is: ‘Removal of neurostimulator system for treatment of central sleep apnea; pulse generator only.’

3. Procedure

1. The provider prepares the patient for the procedure and administers anesthesia.
2. An incision is made over the previously placed generator.
3. The provider disconnects the leads and removes the pulse generator.
4. Any bleeding is controlled and the incision(s) are closed.

4. Qualifying circumstances

CPT 0428T is used when the patient has a neurostimulator system for the treatment of central sleep apnea and only the pulse generator needs to be removed. This procedure is performed when there is a need to replace or repair the pulse generator, or if the patient no longer requires the neurostimulator system.

5. When to use CPT code 0428T

CPT code 0428T should be used when the provider is specifically removing the pulse generator of a neurostimulator system used for the treatment of central sleep apnea. It should not be used if the entire system is being removed or if the generator is being replaced or inserted.

6. Documentation requirements

To support a claim for CPT code 0428T, the provider must document the following information:

• Reason for the removal of the pulse generator
• Details of the procedure, including the incision site and any complications
• Confirmation that only the pulse generator was removed, not the entire neurostimulator system
• Any additional procedures performed during the same session
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT code 0428T, ensure that the procedure involves the removal of the pulse generator of a neurostimulator system used for the treatment of central sleep apnea. This code should not be reported if the entire system is being removed or if the generator is being replaced or inserted. It is important to follow any additional guidelines provided by the payer or coding guidelines to ensure accurate billing.

8. Historical information

CPT code 0428T 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 provider removes the pulse generator of a neurostimulator system used to treat central sleep apnea in a patient.
2. During a procedure, the provider disconnects and removes the pulse generator of a neurostimulator system for the treatment of central sleep apnea.
3. A patient undergoes a surgery to remove the pulse generator of their neurostimulator system used for the treatment of central sleep apnea.
4. The provider performs a procedure to remove the pulse generator of a neurostimulator system in a patient with central sleep apnea.
5. A neurologist removes the pulse generator of a neurostimulator system used for the treatment of central sleep apnea in a patient.
6. A surgeon removes the pulse generator of a neurostimulator system during a procedure for the treatment of central sleep apnea.
7. During a surgical intervention, the pulse generator of a neurostimulator system used to treat central sleep apnea is removed.
8. A patient undergoes a procedure to remove the pulse generator of their neurostimulator system for the treatment of central sleep apnea.
9. The provider removes the pulse generator of a neurostimulator system used for the treatment of central sleep apnea in a patient with respiratory issues.
10. A surgeon performs a procedure to remove the pulse generator of a neurostimulator system in a patient with central sleep apnea.