CPT® Code 0496T

Add-On Code

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; each additional hour (List separately in addition to code for primary procedure)

The CPT® Code 0496T 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 comprehensive assessment of the lung's physiological and laboratory parameters to ensure optimal functioning during the ex vivo lung perfusion (EVLP) process. 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. Once these initial steps are completed, the cadaver donor lung(s) require meticulous monitoring to evaluate their viability and function. During the monitoring phase, various assessments are conducted, including the evaluation of gas exchange through arterial blood gases (ABGs) obtained from the perfusate fluid at the left atrial cannula and each pulmonary vein. The lungs are ventilated with 100% oxygen for a duration of five minutes to facilitate accurate gas exchange analysis. Additionally, flexible bronchoscopy is utilized to inspect the large airways for any abnormalities. This monitoring process is not a one-time event; it involves repeated evaluations of bronchoscopy and ABGs every hour, along with visual and manual examinations to check for conditions such as atelectasis, consolidation, and pulmonary edema. To further assess lung viability, a pulmonary recruitment test is performed every 30 minutes, which involves increasing the ventilator's tidal volume and inspiratory hold settings. A lung deflation test is also conducted at the start of ventilation and subsequently every hour to evaluate lung compliance. In cases where one lung is determined to be non-viable during the EVLP, perfusion of the contralateral lung continues to assess its viability independently. The codes 0495T and 0496T are specifically designated for reporting the initiation and ongoing monitoring of cadaver donor lung(s) during this intricate procedure, ensuring that all necessary physiological and laboratory assessments are documented accurately.