How To Use CPT Code 0435T

CPT 0435T describes the evaluation and programming of an implanted neurostimulator pulse generator system for central sleep apnea. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples.

1. What is CPT Code 0435T?

CPT 0435T can be used to describe the evaluation and programming services provided by a healthcare provider for an implanted neurostimulator pulse generator system used to treat central sleep apnea. This code is used for a single programming session that is not associated with the insertion or replacement of the system or its components.

2. Official Description

The official description of CPT code 0435T is: ‘Programming device evaluation of implanted neurostimulator pulse generator system for central sleep apnea; single session.’

3. Procedure

1. The healthcare provider connects a portable programming device to the pulse generator.
2. They analyze and review several parameters of the stored data, comparing it to current readings.
3. They adjust the programming of the device to optimize its function and evaluate certain aspects of its performance.
4. The provider may also analyze and review the data retrieved from the device to ensure its current programming is optimal.
5. This code should only be reported for programming of an implanted neurostimulator pulse generator system for central sleep apnea.

4. Qualifying circumstances

Patients eligible to receive CPT 0435T services are those with central sleep apnea who have an implanted neurostimulator pulse generator system. This system consists of a transvenously placed stimulation lead, a sensing lead, and an implantable pulse generator. The programming session should not be associated with the insertion or replacement of the system or its components.

5. When to use CPT code 0435T

CPT code 0435T should be used when a healthcare provider performs a single programming session for an implanted neurostimulator pulse generator system for central sleep apnea. This code should not be used for programming during a sleep study or for interrogation of the pulse generator not associated with insertion or removal procedures.

6. Documentation requirements

To support a claim for CPT 0435T, the healthcare provider must document the following information:

• Patient’s diagnosis of central sleep apnea
• Specific details of the programming session, including the start and end time
• Parameters analyzed and adjusted during the session
• Comparison of stored data to current readings
• Analysis and review of retrieved data
• Signature of the healthcare provider performing the programming session

7. Billing guidelines

When billing for CPT 0435T, ensure that the programming session is not associated with the insertion or replacement of the neurostimulator pulse generator system or its components. There are other codes available for programming during a sleep study or interrogation of the pulse generator. Follow the specific guidelines provided by the payer for accurate billing and use appropriate modifiers if necessary.

8. Historical information

CPT 0435T 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 healthcare provider performs an evaluation and programming session for an implanted neurostimulator pulse generator system for central sleep apnea.
2. A patient with central sleep apnea undergoes a programming session to optimize the function of their implanted neurostimulator pulse generator system.
3. A healthcare provider analyzes and adjusts the programming of an implanted neurostimulator pulse generator system for a patient with central sleep apnea.
4. A programming session is conducted to evaluate the performance of an implanted neurostimulator pulse generator system used to treat central sleep apnea.
5. A patient receives a single programming session for their implanted neurostimulator pulse generator system for central sleep apnea.
6. A healthcare provider reviews and adjusts the programming of an implanted neurostimulator pulse generator system to optimize its function for a patient with central sleep apnea.
7. A programming session is performed to analyze the data stored in an implanted neurostimulator pulse generator system and adjust its programming for a patient with central sleep apnea.
8. A patient with central sleep apnea undergoes a programming session to evaluate the parameters of their implanted neurostimulator pulse generator system.
9. A healthcare provider analyzes the data retrieved from an implanted neurostimulator pulse generator system and adjusts its programming for a patient with central sleep apnea.
10. A programming session is conducted to optimize the function of an implanted neurostimulator pulse generator system used for the treatment of central sleep apnea.