How To Use CPT Code 0678T

CPT 0678T describes the laparoscopic repositioning of diaphragmatic lead(s) for the augmentation of cardiac function in patients with heart failure. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples.

1. What is CPT Code 0678T?

CPT 0678T can be used to describe the laparoscopic repositioning of diaphragmatic lead(s) for the augmentation of cardiac function in patients with heart failure. This code is used when a provider uses a laparoscopic approach to reposition an additional lead of a synchronized diaphragmatic stimulation system and connects it to an existing pulse generator.

2. Official Description

The official description of CPT code 0678T is: ‘Laparoscopic repositioning of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; each additional repositioned lead (List separately in addition to code for primary procedure).’ This code should be used in conjunction with CPT code 0677T and should not be reported with codes 0674T, 0675T, 0676T, 0679T, 0680T, 0681T, 0682T, 0683T, 0684T, or 0685T.

3. Procedure

1. During the same session as the repositioning of an initial lead, the provider uses a laparoscopic approach to reposition an additional lead of a synchronized diaphragmatic stimulation system.
2. The provider ensures that the lead is connected to an existing pulse generator.
3. The provider may also perform interrogation and programming of the device.
4. The synchronized diaphragmatic stimulation system uses small shocks from the lead electrodes to stimulate the diaphragm below the heart.
5. The stimulation is synchronized with the cardiac cycle and aims to improve the filling and emptying of the heart in patients with heart failure.

4. Qualifying circumstances

CPT 0678T is used for patients with heart failure who require the repositioning of an additional lead of a synchronized diaphragmatic stimulation system. The laparoscopic approach is chosen to reposition the lead(s) on the underside of the diaphragm. The provider ensures that the lead is connected to an existing pulse generator to complete the procedure.

5. When to use CPT code 0678T

CPT code 0678T should be used when a provider performs the laparoscopic repositioning of an additional lead of a synchronized diaphragmatic stimulation system for the augmentation of cardiac function in patients with heart failure. This code should not be used in conjunction with codes 0674T-0685T, except for code 0677T for the repositioning of the first lead.

6. Documentation requirements

To support a claim for CPT code 0678T, the provider must document the following information:

• Indication for the repositioning of the additional lead(s)
• Details of the laparoscopic procedure, including the approach and technique used
• Date of the procedure
• Connection of the lead(s) to the existing pulse generator
• Interrogation and programming of the device, if performed
• Signature of the provider

7. Billing guidelines

When billing for CPT code 0678T, ensure that the laparoscopic repositioning of an additional lead(s) is performed by a qualified provider. This code should be reported in conjunction with code 0677T for the repositioning of the first lead. It should not be reported with codes 0674T-0685T. It is important to follow the specific guidelines provided by payers for accurate reimbursement.

8. Historical information

CPT code 0678T was added to the Current Procedural Terminology system on January 1, 2022. There have been no updates to the code since its addition.

9. Examples

1. A provider performs the laparoscopic repositioning of an additional lead of a synchronized diaphragmatic stimulation system for a patient with heart failure.
2. During the same session, the provider connects the lead to an existing pulse generator and ensures proper functioning of the device.
3. The laparoscopic approach allows for precise repositioning of the lead(s) on the underside of the diaphragm.
4. The synchronized diaphragmatic stimulation system aims to improve the cardiac function of the patient with heart failure.
5. The procedure is documented and signed by the provider for accurate billing and reimbursement.