How To Use CPT Code 0484T

CPT 0484T describes the transcatheter mitral valve implantation/replacement (TMVI) procedure, specifically through a transthoracic exposure. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples.

1. What is CPT Code 0484T?

CPT 0484T can be used to describe the transcatheter mitral valve implantation/replacement (TMVI) procedure, specifically when performed through a transthoracic exposure. This code is used when a provider inserts a catheter through the chest and implants or replaces a prosthetic mitral valve to treat mitral valve prolapse or malfunction.

2. Official Description

The official description of CPT code 0484T is: ‘Transcatheter mitral valve implantation/replacement (TMVI) with prosthetic valve; transthoracic exposure (eg, thoracotomy, transapical)’

3. Procedure

1. After appropriate patient preparation and anesthesia, the provider makes an incision through the chest and exposes an artery for catheter delivery.
2. A catheter is inserted, and the provider approaches the mitral valve through the apex of the ventricle (transapical approach).
3. The provider may need to revise the valve opening to ensure proper sizing.
4. An artificial valve is implanted between the left ventricle and atrium.
5. The provider ensures the patient’s heart returns to normal function, checks for bleeding, and closes the incision after removing the catheter.

4. Qualifying circumstances

Patients eligible for CPT 0484T are those with mitral valve prolapse or malfunction who require transcatheter mitral valve implantation or replacement. The procedure must be performed through a transthoracic exposure, such as thoracotomy or transapical approach.

5. When to use CPT code 0484T

CPT code 0484T should be used when a provider performs transcatheter mitral valve implantation or replacement through a transthoracic exposure. It is important to ensure that the procedure meets the specific criteria outlined in the code description.

6. Documentation requirements

To support a claim for CPT 0484T, the provider must document the following information:

• Patient’s diagnosis of mitral valve prolapse or malfunction
• Details of the transthoracic exposure performed (e.g., thoracotomy, transapical approach)
• Date of the procedure
• Specific steps taken during the procedure, including any revisions to the valve opening
• Confirmation of normal heart function post-procedure
• Any complications or follow-up care provided
• Provider’s signature

7. Billing guidelines

When billing for CPT 0484T, ensure that the procedure meets the specific criteria outlined in the code description. It is important to accurately document the transthoracic exposure performed and any additional procedures or services provided. Be aware of any Medicare changes or specific billing requirements that may apply.

8. Historical information

CPT 0484T was added to the Current Procedural Terminology system on January 1, 2018. It was also added to the Inpatient Only (IPO) list for Medicare in 2018.

9. Examples

1. A provider performs transcatheter mitral valve replacement through a transthoracic exposure using a catheter delivery system.
2. During the procedure, the provider revises the valve opening to ensure proper sizing before implanting an artificial valve.
3. A patient with mitral valve prolapse undergoes transcatheter mitral valve implantation through a transapical approach.
4. The provider confirms normal heart function post-procedure and provides follow-up care to monitor the patient’s progress.
5. A catheter is inserted through the chest, and the provider performs transcatheter mitral valve replacement using a thoracotomy approach.
6. After the procedure, the provider checks for any bleeding and closes the incision.
7. A patient with mitral valve malfunction undergoes transcatheter mitral valve implantation through a transthoracic exposure.
8. The provider ensures a return to normal heart function and documents any complications or additional procedures performed.
9. During the procedure, the provider carefully selects the artery for catheter delivery to access the mitral valve.
10. An artificial valve is successfully implanted between the left ventricle and atrium, restoring proper valve function.