How To Use CPT Code 0543T

CPT 0543T describes a cardiac valve repair procedure that involves the placement of artificial chordae tendineae to treat mitral valve regurgitation. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples.

1. What is CPT Code 0543T?

CPT 0543T can be used to describe a cardiac valve repair procedure that specifically focuses on the mitral valve. This code is used when the provider performs a transapical approach, accessing the valve through the top of the left ventricle, and places artificial fibrous bands called chordae tendineae to hold the valve in place and prevent prolapse and treat mitral valve regurgitation.

2. Official Description

The official description of CPT code 0543T is: ‘Transapical mitral valve repair, including transthoracic echocardiography, when performed, with placement of artificial chordae tendineae.’

3. Procedure

1. The provider makes a small thoracotomy incision in the patient’s chest over the left ventricle.
2. Using echocardiographic guidance, the provider inserts a specialized grasping mechanism with a fiberoptic monitor and needle system through the incision.
3. The provider advances the instrumentation across the mitral valve and into the left atrium in the chordal free zone.
4. Using the grasping mechanism, the provider grasps the free edge of the mitral valve leaflet and attaches one or more e-PTFE Gore-Tex sutures to the leaflet.
5. The other ends of the sutures are brought back and tied to the papillary muscles in the left ventricular apex after tension is adjusted to reduce mitral regurgitation.
6. The provider removes the instrument, closes the incision in the ventricle, inserts a pleural drain, and closes the chest incision in layers.

4. Qualifying circumstances

CPT 0543T is performed on patients with mitral valve regurgitation, a condition in which the mitral valve fails to close properly, resulting in reverse flow of blood from the left ventricle to the left atrium. The procedure is performed on a beating heart, and the patient is not placed on cardiopulmonary bypass. The provider must use a transapical approach and place artificial chordae tendineae to repair the valve.

5. When to use CPT code 0543T

CPT code 0543T should be used when the provider performs a transapical mitral valve repair procedure with the placement of artificial chordae tendineae. This code is specific to the mitral valve and should not be used for other cardiac valve repair procedures.

6. Documentation requirements

To support a claim for CPT 0543T, the provider must document the following information:

• Patient’s diagnosis of mitral valve regurgitation
• Details of the procedure, including the transapical approach and placement of artificial chordae tendineae
• Date of the procedure
• Any additional procedures performed, such as transthoracic echocardiography
• Any complications or adverse events
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 0543T, ensure that the procedure meets the qualifying circumstances, including the transapical approach and placement of artificial chordae tendineae. It is important to follow payer guidelines and seek prior authorization if necessary. Report any additional procedures performed, such as transthoracic echocardiography, using the appropriate codes.

8. Historical information

CPT 0543T was added to the Current Procedural Terminology system on January 1, 2020. It was initially designated as an Inpatient Only (IPO) procedure.

9. Examples

1. A provider performs a transapical mitral valve repair procedure with the placement of artificial chordae tendineae to treat mitral valve regurgitation.
2. A patient with mitral valve regurgitation undergoes a transapical approach procedure, during which the provider places artificial chordae tendineae to repair the valve.
3. A provider performs a cardiac valve repair procedure specifically targeting the mitral valve using a transapical approach and placing artificial chordae tendineae.
4. A patient with mitral valve regurgitation undergoes a transapical mitral valve repair procedure, during which the provider places artificial chordae tendineae to improve valve function.
5. A provider performs a transapical approach procedure to repair the mitral valve by placing artificial chordae tendineae, effectively treating mitral valve regurgitation.
6. A patient with mitral valve regurgitation receives a transapical mitral valve repair procedure, during which the provider places artificial chordae tendineae to correct the valve dysfunction.
7. A provider performs a cardiac valve repair procedure using a transapical approach and placing artificial chordae tendineae to treat mitral valve regurgitation in a patient.
8. A patient undergoes a transapical mitral valve repair procedure, during which the provider places artificial chordae tendineae to address mitral valve regurgitation.
9. A provider performs a transapical approach procedure to repair the mitral valve by placing artificial chordae tendineae, effectively treating mitral valve regurgitation in a patient.
10. A patient with mitral valve regurgitation receives a transapical mitral valve repair procedure, during which the provider places artificial chordae tendineae to correct the valve dysfunction and improve cardiac function.