CPT® Code 0681T

Relocation of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, with connection to existing dual leads

A permanent implantable synchronized diaphragmatic stimulation (SDS) system is designed to enhance cardiac function, particularly in patients experiencing moderate to severe heart failure while maintaining preserved ventricular synchrony. This innovative system works by stimulating 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 two bipolar active fixation leads that are implanted on the underside of the diaphragm, a pulse generator, and programming software. The pulse generator is responsible for sending a small electrical impulse to stimulate a specific area of the diaphragm, ensuring that normal breathing is not affected. In cases where the existing pulse generator needs to be relocated—often due to complications such as pain, discomfort, necrosis, hematoma, infection, or tissue erosion at the original site—CPT® Code 0681T is utilized. This code specifically refers to the procedure of relocating the pulse generator only, while maintaining the connection to the existing dual leads. The relocation process involves creating a new subcutaneous pocket in the abdomen to house the pulse generator, which is crucial for detecting cardiac activity. This procedure is essential for ensuring the continued effectiveness of the SDS system and the overall well-being of the patient.