CPT® Code 0455T

Deleted

Removal of permanently implantable aortic counterpulsation ventricular assist system; complete system (aortic counterpulsation device, vascular hemostatic seal, mechano-electrical skin interface and electrodes)

The procedure described by CPT® Code 0455T involves the removal of a permanently implantable aortic counterpulsation ventricular assist system. This system is utilized primarily in the management of acute cardiogenic shock or end-stage chronic heart failure. The primary function of the device is to reduce the workload of the left ventricle while simultaneously enhancing cardiac output and blood flow. The aortic counterpulsation device comprises several components, including a pneumatic pump, a console that operates the pump using pressurized air, and electrocardiogram electrodes that facilitate synchronization with the patient's heartbeat. The pump is surgically placed in a subcutaneous pocket located above the pectoralis muscle, with a pneumatic drive line exiting through the skin in the right upper abdomen to connect to the console. An interposition vascular graft is surgically anastomosed to the subclavian artery, allowing for effective blood flow management, while the main graft connects to the pump. Additionally, subcutaneous electrocardiogram electrodes are strategically positioned on the chest wall and linked to the console, with mechano-electrical skin interface leads placed over the wrist, finger, or ankle to capture the heartbeat and ensure proper synchronization of the pump. The removal procedure entails making an incision to access the pump, vascular graft, pneumatic drive tubing, and any subcutaneous electrodes. The device is clamped at the subclavian artery, the vascular graft is excised, and the subclavian artery is repaired. The pneumatic drive tubing and electrodes are disconnected, allowing for the complete removal of the device. Code 0455T specifically reports the removal of the entire system, which includes the aortic counterpulsation device, vascular hemostatic seal, mechano-electrical skin interface, and electrodes.