CPT® Code 0495T

Initiation and monitoring marginal (extended) cadaver donor lung(s) organ perfusion system by physician or qualified health care professional, including physiological and laboratory assessment (eg, pulmonary artery flow, pulmonary artery pressure, left atrial pressure, pulmonary vascular resistance, mean/peak and plateau airway pressure, dynamic compliance and perfusate gas analysis), including bronchoscopy and X ray when performed; first two hours in sterile field

The CPT® Code 0495T refers to the initiation and monitoring of marginal (extended) cadaver donor lung(s) organ perfusion system, which is a critical procedure performed by a physician or qualified health care professional. This process involves a series of detailed assessments and interventions to ensure the viability of donor lungs prior to transplantation. The procedure begins with the cannulation of the main pulmonary artery and left atrial cuff, followed by the establishment of lung perfusion and endotracheal intubation with ventilation on an ex vivo lung perfusion (EVLP) system. During this procedure, the physician closely monitors various physiological parameters to evaluate lung function and gas exchange. This includes the assessment of pulmonary artery flow, pulmonary artery pressure, left atrial pressure, pulmonary vascular resistance, and airway pressures, as well as dynamic compliance and perfusate gas analysis. The monitoring is comprehensive and involves the collection of arterial blood gases (ABGs) from the perfusate fluid at the left atrial cannula and each pulmonary vein, with the lungs ventilated on 100% oxygen for a specified duration. Additionally, flexible bronchoscopy is performed to visually inspect the large airways for any abnormalities. The procedure requires repeated evaluations, including bronchoscopy and ABG analysis, conducted hourly to monitor for potential complications such as atelectasis, consolidation, and pulmonary edema. A pulmonary recruitment test is also performed every 30 minutes to assess lung recruitment by adjusting ventilator settings. If one lung is determined to be non-viable during the EVLP process, perfusion of the contralateral lung continues to assess its viability for transplantation. This meticulous monitoring and assessment are crucial for ensuring the success of lung transplantation and optimizing patient outcomes.