CPT® Code 0678T

Add-On Code

Laparoscopic repositioning of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; each additional repositioned lead (List separately in addition to code for primary procedure)

The CPT® Code 0678T refers to the laparoscopic repositioning of additional diaphragmatic lead(s) as part of a permanent implantable synchronized diaphragmatic stimulation (SDS) system. This advanced medical procedure is designed to enhance cardiac function, particularly in patients suffering from moderate to severe heart failure while maintaining preserved ventricular synchrony. The SDS system operates by stimulating the diaphragm in synchronization with the heart's natural rhythm, which helps to 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 itself. The system comprises two bipolar active fixation leads that are implanted on the underside of the diaphragm, a pulse generator that detects cardiac activity, and programming software to manage the device's operation. The procedure is performed using a minimally invasive laparoscopic technique, which involves making two small incisions, each approximately half an inch in length, to access the diaphragm for lead implantation. Additionally, a subcutaneous pocket is created in the abdominal area to accommodate the pulse generator. The stimulation provided by the leads is carefully calibrated to target a specific area of the diaphragm, ensuring that normal breathing is not affected. This code is specifically used for reporting each additional lead that is repositioned, following the repositioning of the first lead, which is reported under CPT® Code 0677T. The repositioning may be necessary due to various factors such as lead movement, malpositioning, infection, hematoma, or discomfort at the original site. Proper evaluation and manipulation of the lead's position are critical to ensure optimal functioning of the SDS system.