How To Use CPT Code 0646T

CPT 0646T describes a procedure known as transcatheter tricuspid valve implantation (TTVI) or replacement. This article will provide an overview of what CPT code 0646T entails, including its official description, the procedure itself, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples.

1. What is CPT Code 0646T?

CPT 0646T is a code that represents the transcatheter tricuspid valve implantation or replacement procedure. This procedure involves the insertion of a prosthetic tricuspid valve using a catheter, which is threaded through a vessel and guided to the heart through a small incision in the skin.

2. Official Description

The official description of CPT code 0646T is: ‘Transcatheter tricuspid valve implantation (TTVI)/replacement with prosthetic valve, percutaneous approach, including right heart catheterization, temporary pacemaker insertion, and selective right ventricular or right atrial angiography, when performed.’

3. Procedure

1. First, the patient is appropriately prepped and anesthetized.
2. Then, the healthcare provider makes a small incision through the skin to access the selected vessel.
3. A catheter is inserted and navigated through the blood vessels until it reaches the heart.
4. If necessary, a temporary pacemaker may be inserted for rapid pacing.
5. The provider may use angiography and intracardiac echocardiography to guide the procedure.
6. The right heart is catheterized to access the tricuspid valve.
7. The prosthetic tricuspid valve is implanted or replaced.
8. The provider ensures the patient’s heart function returns to normal.
9. The catheter is then withdrawn, pressure is applied to control any bleeding, and the small incision is closed.

4. Qualifying circumstances

CPT code 0646T is used for patients who require transcatheter tricuspid valve implantation or replacement. This procedure is typically performed on patients with tricuspid regurgitation, a condition where the tricuspid valve does not close properly, causing blood to flow back into the right atrium. The procedure is performed by a healthcare provider who is experienced in this specific technique and has the necessary qualifications.

5. When to use CPT code 0646T

CPT code 0646T should be used when a healthcare provider performs transcatheter tricuspid valve implantation or replacement using a percutaneous approach. It is important to note that this code should not be reported in conjunction with certain other codes, such as those for temporary pacemaker insertion or diagnostic right heart catheterization procedures intrinsic to the valve repair procedure.

6. Documentation requirements

To support a claim for CPT code 0646T, the healthcare provider must document the following information:

• Patient’s diagnosis and the need for transcatheter tricuspid valve implantation or replacement
• Details of the procedure performed, including right heart catheterization, temporary pacemaker insertion, and selective right ventricular or right atrial angiography
• Date and duration of the procedure
• Any additional procedures or interventions performed during the same session
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT code 0646T, it is important to ensure that the procedure meets the specific criteria outlined in the code description. The healthcare provider should also be aware of any specific guidelines or restrictions related to reporting this code in conjunction with other codes. It is recommended to review the official coding guidelines and consult with payers for any additional billing requirements or considerations.

8. Historical information

CPT code 0646T was added to the Current Procedural Terminology system on July 1, 2021. As a relatively new addition, there may not be significant historical information or updates available for this code at this time.

9. Examples

1. A healthcare provider performs transcatheter tricuspid valve implantation for a patient with severe tricuspid regurgitation.
2. Using a percutaneous approach, a healthcare provider replaces a malfunctioning tricuspid valve with a prosthetic valve for a patient with tricuspid valve disease.
3. Transcatheter tricuspid valve implantation is performed on a patient with congenital heart disease to improve tricuspid valve function.
4. A healthcare provider performs transcatheter tricuspid valve replacement for a patient with tricuspid valve stenosis.
5. Using a catheter-based technique, a healthcare provider implants a prosthetic tricuspid valve for a patient with tricuspid valve insufficiency.
6. Transcatheter tricuspid valve replacement is performed on a patient with tricuspid valve endocarditis.
7. A healthcare provider performs transcatheter tricuspid valve implantation for a patient with tricuspid valve prolapse.
8. Using a percutaneous approach, a healthcare provider replaces a degenerated tricuspid valve with a prosthetic valve for a patient with tricuspid valve calcification.
9. Transcatheter tricuspid valve implantation is performed on a patient with tricuspid valve regurgitation following previous cardiac surgery.
10. A healthcare provider performs transcatheter tricuspid valve replacement for a patient with tricuspid valve annular dilatation.