CPT® Code 0695T

Body surface-activation mapping of pacemaker or pacing cardioverter-defibrillator lead(s) to optimize electrical synchrony, cardiac resynchronization therapy device, including connection, recording, disconnection, review, and report; at time of implant or replacement

The CPT® Code 0695T refers to a specialized procedure known as body surface-activation mapping (BSAM) of pacemaker or pacing cardioverter-defibrillator lead(s). This procedure is performed to optimize electrical synchrony in patients undergoing cardiac resynchronization therapy (CRT). The primary goal of BSAM is to enhance the effectiveness of CRT by allowing for individualized programming of the CRT device, which is crucial for minimizing electrical dyssynchrony within the heart. During this procedure, a body surface-activation mapping system is utilized, which typically employs between 64 to 120 electrodes strategically placed to cover a larger area of the torso compared to a standard 12-lead electrocardiogram (ECG). These electrodes are incorporated into a vest that is worn by the patient, with a conducting gel applied to the chest and back to ensure accurate data collection. The information gathered from this mapping provides comprehensive insights into the distribution of electrocardiac activity, specifically focusing on the QRS, ST, and T potentials on the body surface. The activation time is determined by measuring the interval from the onset of the QRS complex to the steepest negative slope, allowing for the creation of detailed body surface maps that illustrate activation times. These maps are instrumental in assessing and addressing changes in electrical dyssynchrony, with specific parameters such as the standard deviation of activation times (SDAT) and the average left thorax activation time (LVAT) being utilized to optimize the placement of the left ventricular lead and the programming of the CRT device. Notably, the application of BSAM can lead to significant improvements in ventricular activation time, potentially enhancing it by up to 46% compared to standard pacing settings. The code 0695T should be reported when body surface activation mapping is conducted, including the review and report, at the time of CRT device implantation or replacement.