How To Use CPT Code 0545T

CPT 0545T describes a percutaneous procedure known as transcatheter tricuspid valve annulus reconstruction with implantation of an adjustable annulus reconstruction device. This article will provide a comprehensive overview of the code, including its official description, the procedure itself, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples.

1. What is CPT Code 0545T?

CPT 0545T is a code used to describe a specific percutaneous procedure called transcatheter tricuspid valve annulus reconstruction with implantation of an adjustable annulus reconstruction device. This procedure is performed to treat tricuspid regurgitation by reconstructing and tightening the dilated annulus of the tricuspid valve, which is located between the right upper and lower chambers of the heart.

2. Official Description

The official description of CPT code 0545T is: ‘Transcatheter tricuspid valve annulus reconstruction with implantation of adjustable annulus reconstruction device, percutaneous approach.’ It is important to note that this code should not be reported in conjunction with certain other codes, such as those related to diagnostic left and right heart catheterization procedures or coronary angiography procedures intrinsic to the annular repair procedure.

3. Procedure

1. The procedure begins with the provider 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 tricuspid valve commissure.
4. A transseptal steerable sheath (TSS) is then advanced over a guidewire into the right atrium.
5. The implant, which is an adjustable annulus reconstruction device, is delivered through the sheath and positioned near the annulus of the tricuspid valve.
6. Anchors are inserted through the implant fabric into the annular tissue surrounding the tricuspid valve, securing the implant in place.
7. The provider may use fluoroscopic and TEE guidance to maneuver the implant catheter to each targeted anchoring point.
8. After deploying the last anchor, the provider disconnects the implant from the implant catheter.
9. A size adjustment tool is then inserted through the TSS to the implant adjustment mechanism, allowing the provider to reduce the implant size and control tricuspid regurgitation.
10. Finally, the size adjustment tool and the TSS are removed, leaving the implant in place. The provider closes the incision in layers and ensures hemostasis.

4. Qualifying circumstances

CPT 0545T is typically performed on patients with tricuspid regurgitation, a condition characterized by the backward flow of blood from the right ventricle into the right atrium due to a malfunctioning tricuspid valve. This procedure is performed percutaneously by inserting an adjustable annulus reconstruction device via a catheter, without the need for cardiopulmonary bypass. It is important to note that certain other procedures, such as coronary angiography or diagnostic left and right heart catheterization, should not be reported in conjunction with CPT 0545T.

5. When to use CPT code 0545T

CPT code 0545T should be used when a provider performs transcatheter tricuspid valve annulus reconstruction with implantation of an adjustable annulus reconstruction device using a percutaneous approach. This code is appropriate for reporting this specific procedure and should not be used for other related procedures or in conjunction with certain other codes, as mentioned in the official description.

6. Documentation requirements

To support a claim for CPT 0545T, the provider must document the following information:

• Patient’s diagnosis of tricuspid regurgitation
• Description of the procedure performed, including the use of an adjustable annulus reconstruction device
• Date and details of the procedure, including the specific steps taken
• Any additional procedures or services provided during the same encounter
• Signature of the performing provider

7. Billing guidelines

When billing for CPT 0545T, it is important to ensure that the procedure meets the specific criteria outlined in the code description. The use of an adjustable annulus reconstruction device via a percutaneous approach should be documented. It is also important to follow any additional guidelines provided by payers regarding the reporting of this procedure. Additionally, certain other procedures should not be reported in conjunction with CPT 0545T, as mentioned in the official description.

8. Historical information

CPT code 0545T was added to the Current Procedural Terminology system on July 1, 2019. As of the provided information, there have been no updates or changes to the code since its addition. It is important to stay updated with any changes or revisions that may occur in the future.

9. Examples

1. A patient with tricuspid regurgitation undergoes transcatheter tricuspid valve annulus reconstruction with implantation of an adjustable annulus reconstruction device using a percutaneous approach.
2. A provider performs the procedure on a patient with severe tricuspid regurgitation to improve their heart function and reduce symptoms.
3. Transcatheter tricuspid valve annulus reconstruction with implantation of an adjustable annulus reconstruction device is performed on a patient who is not a candidate for open-heart surgery.
4. A provider successfully performs the procedure on a patient with a dilated tricuspid valve annulus, restoring proper valve function.
5. A patient with tricuspid regurgitation undergoes the percutaneous procedure to improve their quality of life and reduce the risk of complications.