How To Use CPT Code 0569T

CPT 0569T describes a percutaneous approach to repair a defect in the tricuspid valve using a prosthesis. This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples of CPT code 0569T.

1. What is CPT Code 0569T?

CPT 0569T can be used to describe a specific procedure for repairing a defect in the tricuspid valve using a percutaneous approach. This code is used when a provider places a prosthesis through a catheter that is inserted percutaneously to treat conditions such as tricuspid valve regurgitation.

2. Official Description

The official description of CPT code 0569T is: ‘Transcatheter tricuspid valve repair, percutaneous approach; initial prosthesis.’

3. Procedure

1. The provider begins by making a small incision in the skin and inserting a catheter into the left subclavian or axillary vein.
2. Using fluoroscopic guidance, the provider advances the catheter over a guidewire to the right atrium and the orifice of the tricuspid valve.
3. The provider may perform angiography and roadmapping to guide the placement of the prosthesis.
4. Using a balloon spacer, the provider reduces the opening of the tricuspid valve orifice and reduces regurgitation.
5. The provider adjusts the position of the spacer until it is in the optimum position and stabilizes it by anchoring a rail at the right ventricular apex.
6. The provider withdraws the catheter and closes the incisions, ensuring hemostasis.

4. Qualifying circumstances

Patients eligible for CPT 0569T are those with tricuspid valve regurgitation or other conditions that require repair of the tricuspid valve using a percutaneous approach. The procedure must be performed by a qualified provider and involve the initial placement of a prosthesis.

5. When to use CPT code 0569T

CPT code 0569T should be used when a provider performs a percutaneous tricuspid valve repair procedure using an initial prosthesis. This code should not be used for other types of tricuspid valve repair procedures or for subsequent prosthesis placements.

6. Documentation requirements

To support a claim for CPT 0569T, the provider must document the following information:

• Patient’s diagnosis and the need for tricuspid valve repair
• Details of the procedure, including the specific prosthesis used
• Date and time of the procedure
• Any additional procedures performed in conjunction with CPT 0569T
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 0569T, ensure that the procedure meets the criteria for a percutaneous tricuspid valve repair using an initial prosthesis. Report additional prosthesis placements with the appropriate add-on code. Be cautious not to confuse CPT 0569T with other codes for different tricuspid valve repair procedures. Follow the specific guidelines for reporting CPT 0569T and any associated procedures.

8. Historical information

CPT 0569T was added to the Current Procedural Terminology system on January 1, 2020. It was also added to the Inpatient Only (IPO) list for Medicare reimbursement in the same year.

9. Examples

1. A provider performs a percutaneous tricuspid valve repair procedure using an initial prosthesis to treat tricuspid valve regurgitation in a patient.
2. Using a catheter inserted percutaneously, a provider places a prosthesis to repair a defect in the tricuspid valve of a patient with tricuspid valve regurgitation.
3. A qualified provider performs a percutaneous tricuspid valve repair procedure using an initial prosthesis for a patient with tricuspid valve dysfunction.
4. Using a percutaneous approach, a provider places a prosthesis to repair a defect in the tricuspid valve of a patient with tricuspid valve regurgitation.
5. A patient undergoes a percutaneous tricuspid valve repair procedure with the initial placement of a prosthesis to treat tricuspid valve dysfunction.
6. A provider performs a percutaneous tricuspid valve repair procedure using an initial prosthesis for a patient with tricuspid valve regurgitation.
7. Using a catheter inserted percutaneously, a qualified provider places a prosthesis to repair a defect in the tricuspid valve of a patient with tricuspid valve dysfunction.
8. A patient with tricuspid valve regurgitation undergoes a percutaneous tricuspid valve repair procedure with the initial placement of a prosthesis.
9. A provider performs a percutaneous tricuspid valve repair procedure using an initial prosthesis to treat tricuspid valve dysfunction in a patient.
10. Using a percutaneous approach, a qualified provider places a prosthesis to repair a defect in the tricuspid valve of a patient with tricuspid valve regurgitation.