How To Use CPT Code 0515T

CPT 0515T describes the insertion of a wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming, as well as imaging supervision and interpretation if performed. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples.

1. What is CPT Code 0515T?

CPT 0515T can be used to describe the insertion of a wireless cardiac stimulator for left ventricular pacing. This procedure involves placing a generator (battery) and a transmitter in separate subcutaneous pockets and connecting them with a cable through a subcutaneous tunnel. A wireless electrode is then inserted into the left ventricle, and the system is tested and programmed. If imaging supervision and interpretation are performed, they are included in this code.

2. Official Description

The official description of CPT code 0515T is: ‘Insertion of wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming, and imaging supervision and interpretation, when performed; complete system (includes electrode and generator [transmitter and battery]).’

3. Procedure

1. The provider creates subcutaneous pockets for the generator (battery) and transmitter, placing them in separate locations.
2. A cable is inserted through a subcutaneous tunnel, connecting the generator and transmitter.
3. An ultrasound probe is used to ensure there is a clear acoustic window for the ultrasound pulses that will stimulate the wireless electrode.
4. The provider administers heparin to prevent blood clots and makes a small incision over the femoral vein.
5. A delivery sheath is advanced retrograde to the left ventricle, and a delivery catheter with the wireless electrode is inserted.
6. The electrode is tested and anchored in the inside wall of the left ventricle.
7. The programming device is used to test and program the wireless pacing electrode.
8. The delivery catheter and sheath are withdrawn, and the incision is closed.

4. Qualifying circumstances

Patients eligible for CPT 0515T are those who require left ventricular pacing using a wireless cardiac stimulator. This procedure is typically performed on patients who need synchronized biventricular pacing. The provider must ensure that there is no bone or lung between the transmitter and the electrode to maintain a clear acoustic window for ultrasound pulses. Sensing electrodes placed on the skin over the transmitter and battery pockets detect right ventricular pacing pulses from a separately implanted device.

5. When to use CPT code 0515T

CPT code 0515T should be used when a wireless cardiac stimulator is inserted for left ventricular pacing. This code is appropriate when the complete system, including the electrode and generator, is inserted. If imaging supervision and interpretation are performed during the procedure, they are also included in this code.

6. Documentation requirements

To support a claim for CPT 0515T, the provider must document the following information:

• Patient’s diagnosis and the need for left ventricular pacing
• Details of the procedure, including the placement of the generator and transmitter, the insertion of the wireless electrode, and any imaging supervision and interpretation performed
• Date and duration of the procedure
• Programming and testing of the wireless pacing electrode
• Any complications or additional procedures performed
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 0515T, ensure that the complete system, including the electrode and generator, is inserted. If imaging supervision and interpretation are performed, they are included in this code. It is important to follow the specific guidelines for reporting CPT code 0515T and to consider any additional codes that may be required for synchronized biventricular pacing or other cardiac resynchronization therapy devices.

8. Historical information

CPT 0515T was added to the Current Procedural Terminology system on January 1, 2019. There have been no updates to the code since its addition.

9. Examples

1. A provider inserts a wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming, and imaging supervision and interpretation, for a patient with heart failure.
2. A patient with cardiac resynchronization therapy requires the insertion of a complete system, including the electrode and generator, for left ventricular pacing using a wireless cardiac stimulator.
3. A provider performs the insertion of a wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming, and imaging supervision and interpretation, for a patient with arrhythmia.
4. A wireless cardiac stimulator, including the electrode and generator, is inserted for left ventricular pacing in a patient with conduction disorders, with imaging supervision and interpretation performed during the procedure.
5. A provider performs the insertion of a complete system, including the electrode and generator, for left ventricular pacing using a wireless cardiac stimulator, including device interrogation and programming, and imaging supervision and interpretation, for a patient with heart block.
6. A patient with synchronized biventricular pacing requires the insertion of a wireless cardiac stimulator, including the electrode and generator, for left ventricular pacing, with imaging supervision and interpretation performed during the procedure.
7. A provider inserts a complete system, including the electrode and generator, for left ventricular pacing using a wireless cardiac stimulator, including device interrogation and programming, and imaging supervision and interpretation, for a patient with dilated cardiomyopathy.
8. A wireless cardiac stimulator, including the electrode and generator, is inserted for left ventricular pacing in a patient with ventricular tachycardia, with imaging supervision and interpretation performed during the procedure.
9. A provider performs the insertion of a complete system, including the electrode and generator, for left ventricular pacing using a wireless cardiac stimulator, including device interrogation and programming, and imaging supervision and interpretation, for a patient with heart valve disease.
10. A patient with synchronized biventricular pacing requires the insertion of a wireless cardiac stimulator, including the electrode and generator, for left ventricular pacing, with imaging supervision and interpretation performed during the procedure.