How To Use CPT Code 0544T

CPT 0544T describes a transcatheter mitral valve annulus reconstruction procedure that involves the percutaneous implantation of an adjustable annulus reconstruction device. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples of CPT code 0544T.

1. What is CPT Code 0544T?

CPT 0544T is a code used to describe a specific procedure known as transcatheter mitral valve annulus reconstruction. This procedure involves the percutaneous implantation of an adjustable annulus reconstruction device to treat mitral regurgitation. It is important to note that this code should not be used for other types of transcatheter mitral valve repair or implantation procedures.

2. Official Description

The official description of CPT code 0544T is: ‘Transcatheter mitral valve annulus reconstruction, with implantation of adjustable annulus reconstruction device, percutaneous approach including transseptal puncture.’

3. Procedure

1. The provider begins by making a small incision through the skin and femoral vein.
2. A catheter is inserted and advanced up to the inferior vena cava under fluoroscopic imaging guidance.
3. Using transesophageal echocardiographic (TEE) guidance, the provider punctures the interatrial septum over the posterior medial mitral valve commissure.
4. A transseptal steerable sheath (TSS) is then advanced over a guidewire into the left atrium.
5. The provider delivers the implant through the sheath and aligns the tip of the implant catheter near the anterior lateral trigone.
6. Using fluoroscopic and TEE guidance, the provider inserts a series of anchors through the implant fabric into the annular tissue surrounding the mitral valve.
7. After deploying the last anchor, the provider disconnects the implant from the implant catheter and uses a size adjustment tool to reduce the implant size and control mitral regurgitation.
8. The size adjustment tool and the transseptal steerable sheath are then removed, leaving the implant in place.
9. The provider removes the catheter and applies pressure over the femoral vein to control bleeding.
10. After ensuring hemostasis, the incision is closed in layers.

4. Qualifying circumstances

CPT code 0544T is used for patients who require transcatheter mitral valve annulus reconstruction to treat mitral regurgitation. This procedure is performed on a beating heart without the use of cardiopulmonary bypass. It is important to note that this code should not be used for other types of mitral valve procedures or for patients who require additional interventions such as cardiopulmonary bypass or ventricular support.

5. When to use CPT code 0544T

CPT code 0544T should be used when a provider performs a transcatheter mitral valve annulus reconstruction procedure with the implantation of an adjustable annulus reconstruction device using a percutaneous approach. It is important to ensure that the procedure meets all the criteria specified in the code description before reporting it.

6. Documentation requirements

To support a claim for CPT code 0544T, the provider must document the following information:

• Patient’s diagnosis and the medical necessity for transcatheter mitral valve annulus reconstruction
• Details of the procedure, including the use of an adjustable annulus reconstruction device and the percutaneous approach
• Date and duration of the procedure
• Imaging guidance used, such as fluoroscopy and transesophageal echocardiography
• Specific steps performed during the procedure, including transseptal puncture and implantation of anchors
• Any additional interventions or procedures performed during the same session
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT code 0544T, it is important to ensure that the procedure meets all the criteria specified in the code description. This code includes various components, such as vascular access, catheterization, device deployment and adjustment, temporary pacemaker insertion, and access site closure. It is important to follow the specific guidelines provided in the code description and to use additional codes when necessary, such as for diagnostic cardiac catheterization or percutaneous coronary interventional procedures.

8. Historical information

CPT code 0544T was added to the Current Procedural Terminology system on an unspecified date. There have been no updates or changes to the code since its addition.

9. Examples

1. A provider performs a transcatheter mitral valve annulus reconstruction procedure with the implantation of an adjustable annulus reconstruction device using a percutaneous approach to treat mitral regurgitation.
2. During the procedure, the provider uses fluoroscopic and transesophageal echocardiographic guidance to puncture the interatrial septum and implant anchors into the annular tissue surrounding the mitral valve.
3. After deploying the anchors, the provider adjusts the size of the implant to control mitral regurgitation.
4. The procedure is successfully completed, and the patient’s condition improves following the intervention.
5. Another provider performs a similar transcatheter mitral valve annulus reconstruction procedure on a different patient, achieving successful outcomes.
6. Both procedures meet the criteria specified in CPT code 0544T and are appropriately documented for billing purposes.
7. It is important to note that these examples are for illustrative purposes only and should not be considered as specific medical advice or indications for the use of CPT code 0544T.