CPT® Code 0466T

Code deleted. See 64582, 64583, 64584.

Official Description

Insertion of chest wall respiratory sensor electrode or electrode array, including connection to pulse generator (List separately in addition to code for primary procedure)

Common Language Description

The CPT® Code 0466T refers to the procedure involving the insertion of a chest wall respiratory sensor electrode or an electrode array. This device is specifically designed to monitor respiratory patterns that are indicative of sleep apnea. Sleep apnea is a condition characterized by repeated interruptions in breathing during sleep, which can lead to various health complications. The implanted sensor electrode or array detects changes in the respiratory patterns by monitoring the muscles of the chest wall. When an abnormal breathing pattern is identified, the connected pulse generator delivers an electrical impulse to the hypoglossal nerve. This stimulation prompts the tongue to move forward, effectively opening the airway and alleviating the obstruction caused by the tongue falling back during sleep. The insertion procedure for the sensor electrode or array involves making an incision in the right ipsilateral mid-infraclavicular region, which allows access to the pulse generator that is placed in a subcutaneous pocket. A tunnel is then created beneath the skin, extending to the area between the 4th and 5th intercostal spaces. The electrode or array is carefully inserted into this tunnel, ensuring that the sensing end is positioned between the interior and exterior intercostal muscles. After the electrode is connected to the pulse generator, the device is tested for proper function, and the incision is subsequently closed. This procedure is also applicable for revision, replacement, or removal of the electrode or array, with specific steps to disconnect, manipulate, or replace the device as necessary.

1. Indications

The insertion of a chest wall respiratory sensor electrode or electrode array, as described by CPT® Code 0466T, is indicated for patients who exhibit symptoms or conditions associated with sleep apnea. The following are the explicitly provided indications for this procedure:

Sleep Apnea Patients diagnosed with sleep apnea, characterized by repeated episodes of airway obstruction during sleep, leading to disrupted breathing patterns.

2. Procedure

The procedure for the insertion of the chest wall respiratory sensor electrode or electrode array involves several detailed steps, as outlined below:

Step 1: Incision An incision is made in the right ipsilateral mid-infraclavicular region. This incision provides access to the subcutaneous pocket where the pulse generator will be placed.
Step 2: Creating the Tunnel A tunnel is created under the skin, extending to the area of the 4th or 5th intercostal space. This tunnel is essential for the proper placement of the electrode or array.
Step 3: Insertion of the Electrode/Array The electrode or electrode array is inserted into the tunnel, ensuring that the sensing end is positioned correctly between the interior and exterior intercostal muscles to effectively monitor respiratory patterns.
Step 4: Connection to Pulse Generator The electrode is then connected to the pulse generator. This connection is crucial for the device to function properly and deliver electrical impulses when abnormal breathing patterns are detected.
Step 5: Device Check After the connection, the device is checked for patency to ensure that it is functioning correctly before closing the incision.
Step 6: Closing the Incision Finally, the incision is closed, completing the procedure.

3. Post-Procedure

Post-procedure care for patients who have undergone the insertion of a chest wall respiratory sensor electrode or electrode array includes monitoring for any signs of complications, such as infection or improper device function. Patients are typically advised to follow up with their healthcare provider to ensure that the device is working as intended and to assess the effectiveness of the treatment for sleep apnea. Additionally, any necessary adjustments or further interventions can be discussed during these follow-up appointments.

Short Descr	INSJ CH WAL RESPIR ELTRD/RA
Medium Descr	INSRT CH WALL RESPIR ELTRD & CONJ PULSE GEN
Long Descr	Insertion of chest wall respiratory sensor electrode or electrode array, including connection to pulse generator (List separately in addition to code for primary procedure)
Status Code	Carriers Price the Code
Global Days	ZZZ - Code Related to Another Service
PC/TC Indicator (26, TC)	9 - Not Applicable
Multiple Procedures (51)	9 - Concept does not apply.
Bilateral Surgery (50)	9 - Concept does not apply.
Physician Supervisions	09 - Concept does not apply.
Assistant Surgeon (80, 82)	9 - Concept does not apply.
Co-Surgeons (62)	9 - Concept does not apply.
Team Surgery (66)	9 - Concept does not apply.
Diagnostic Imaging Family	99 - Concept Does Not Apply
APC Status Indicator	Items and Services Packaged into APC Rates
Berenson-Eggers TOS (BETOS)	none
MUE	Not applicable/unspecified.