How To Use CPT Code 0520T

CPT 0520T describes the removal and replacement of a wireless cardiac stimulator for left ventricular pacing, specifically involving the pulse generator component(s) such as the battery and/or transmitter. This article will provide an overview of the code, including its official description, the procedure involved, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples.

1. What is CPT Code 0520T?

CPT 0520T is a code that is used to describe the removal and replacement of a wireless cardiac stimulator for left ventricular pacing. This procedure involves the removal and replacement of the pulse generator component(s), which includes the battery and/or transmitter. It is important to note that this code should not be reported in conjunction with certain other codes, such as 0515T, 0516T, 0517T, 0518T, 0521T, and 0522T.

2. Official Description

The official description of CPT code 0520T is: ‘Removal and replacement of wireless cardiac stimulator for left ventricular pacing; pulse generator component(s) (battery and/or transmitter), including placement of a new electrode.’

3. Procedure

1. The procedure begins with the patient being appropriately prepped and anesthetized.
2. The provider makes an incision over the previously placed generator battery and transmitter, disconnects the cable connecting them, and removes the devices.
3. The subcutaneous pockets where the previous devices were located are closed with sutures.
4. A new incision is made in a new spot in the midaxillary line, and a pocket is created for the new generator battery.
5. Another incision is made in the chest wall, typically between the 4th and 6th intercostal spaces lateral to the left edge of the sternum, to create a pocket for the new transmitter.
6. The transmitter is placed in the accessory and secured, ensuring there is no bone or lung between it and the electrode in the left ventricle.
7. A subcutaneous tunnel is created between the two pockets, and a cable is inserted through the tunnels and attached to the battery and transmitter.
8. The incisions over the battery and transmitter are closed.
9. Under fluoroscopic guidance, the provider makes a small incision over the femoral vein and advances a delivery sheath retrograde to the left ventricle.
10. A delivery catheter preloaded with a wireless electrode is inserted through the delivery sheath, and the electrode is anchored in the inside wall of the left ventricle.
11. The delivery catheter and sheath are withdrawn, and the small incision is closed.

4. Qualifying circumstances

CPT code 0520T is used when a wireless cardiac stimulator needs to be removed and replaced for left ventricular pacing. This procedure is typically performed on patients who require this type of cardiac stimulation. It is important to note that this code should not be reported in conjunction with certain other codes, as mentioned earlier.

5. When to use CPT code 0520T

CPT code 0520T should be used when a provider performs the removal and replacement of a wireless cardiac stimulator for left ventricular pacing, specifically involving the pulse generator component(s) such as the battery and/or transmitter. It is important to follow the guidelines and not report this code in conjunction with other specified codes.

6. Documentation requirements

To support a claim for CPT code 0520T, the provider must document the following information:

• Patient’s medical history and indication for the procedure
• Details of the procedure, including the removal and replacement of the pulse generator component(s)
• Specific locations of incisions and pockets created
• Use of fluoroscopic guidance, if applicable
• Any complications or additional procedures performed
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT code 0520T, ensure that the procedure involves the removal and replacement of the pulse generator component(s) for left ventricular pacing. It is important to follow the guidelines and not report this code in conjunction with other specified codes. Additionally, consider the location of the testing and the need for fluoroscopic guidance, as these factors may affect how the procedure is coded.

8. Historical information

CPT code 0520T 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 patient requires the removal and replacement of a wireless cardiac stimulator for left ventricular pacing, involving the replacement of the pulse generator component(s) and the placement of a new electrode.
2. A provider performs the removal and replacement of a wireless cardiac stimulator for left ventricular pacing, specifically replacing the battery and transmitter, and placing a new electrode in the left ventricle.
3. During a procedure, a wireless cardiac stimulator’s pulse generator component(s) are removed and replaced, including the placement of a new electrode for left ventricular pacing.
4. A patient undergoes the removal and replacement of a wireless cardiac stimulator’s battery and transmitter, along with the placement of a new electrode in the left ventricle for left ventricular pacing.
5. A provider performs the removal and replacement of a wireless cardiac stimulator’s pulse generator component(s), including the placement of a new electrode, to facilitate left ventricular pacing.
6. During a procedure, a wireless cardiac stimulator’s battery and transmitter are removed and replaced, and a new electrode is placed in the left ventricle for left ventricular pacing.
7. A patient requires the removal and replacement of a wireless cardiac stimulator for left ventricular pacing, involving the replacement of the pulse generator component(s) and the insertion of a new electrode.
8. A provider performs the removal and replacement of a wireless cardiac stimulator for left ventricular pacing, specifically replacing the battery and transmitter, and inserting a new electrode in the left ventricle.
9. During a procedure, a wireless cardiac stimulator’s pulse generator component(s) are removed and replaced, including the insertion of a new electrode for left ventricular pacing.
10. A patient undergoes the removal and replacement of a wireless cardiac stimulator’s battery and transmitter, along with the insertion of a new electrode in the left ventricle for left ventricular pacing.