CPT® Code 0674T

Laparoscopic insertion of new or replacement of permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including an implantable pulse generator and diaphragmatic lead(s)

The procedure described by CPT® Code 0674T involves the laparoscopic insertion of a new or replacement permanent implantable synchronized diaphragmatic stimulation (SDS) system, which is designed to augment cardiac function. This innovative system is particularly beneficial for patients suffering from moderate to severe heart failure, especially when there is preserved ventricular synchrony. The primary function of the SDS system is to stimulate the diaphragm in synchronization with the cardiac cycle, which helps modify chest pressure. This modification facilitates improved filling and emptying of the heart, ultimately enhancing blood flow without placing additional stress on the heart muscle. The system comprises an implantable pulse generator, bipolar active fixation leads, and programming software, all of which work together to optimize cardiac function. During the procedure, a minimally invasive laparoscopic approach is utilized, involving the creation of two small half-inch incisions. Through these incisions, two bipolar leads are implanted on the underside of the diaphragm. Additionally, a small subcutaneous pocket is formed in the abdomen to accommodate the pulse generator, which is responsible for detecting cardiac activity. The leads are then connected to the pulse generator, which delivers a small electrical shock to stimulate a specific area of the diaphragm, ensuring that normal breathing is not affected. This procedure is reported using CPT® Code 0674T when the entire system is implanted or completely replaced. For cases where only the first new diaphragmatic lead is placed or an existing lead is replaced and connected to an already positioned pulse generator, CPT® Code 0675T is used. Furthermore, CPT® Code 0676T is designated for the placement or replacement of each additional lead beyond the first.