On Demand: EP Series Part 2: Device Procedure – New Technology Systems-Webinar Slides

Webinar Slides

Pdf Summary

This MedAxiom webcast reviews coding for new electrophysiology and device technologies, with emphasis on Category III CPT codes, clinical trial billing requirements, and supported coding examples.

It explains that Category III codes are temporary alphanumeric codes used for emerging procedures and technologies. They are reported when available instead of unlisted codes, are usually published twice yearly, may expire after five years, and typically do not carry RVUs or guaranteed payer coverage.

The presentation then covers several device categories:
- <strong>Leadless pacemakers</strong>: single-chamber right ventricular, right atrial, and dual-chamber systems, including insertion, removal, and replacement codes.
- <strong>Extravascular/substernal ICDs (EV-ICD)</strong>: codes for insertion, removal, repositioning, generator-only procedures, and electrophysiologic evaluation.
- <strong>Intracardiac ischemia monitoring systems</strong>: codes for complete system insertion and removal.
- <strong>Wireless left ventricular pacing systems</strong>: codes for insertion and removal/replacement of the electrode and generator components.
- <strong>Cardiac contractility modulation (CCM and CCM-D)</strong>: codes for implant, revision, removal, repositioning, and EP evaluation.
- <strong>Baroreflex activation therapy (BAT)</strong> and <strong>heart failure monitoring devices</strong> such as CardioMEMS and left atrial pressure sensors.

Multiple operative case examples show how to select CPT and ICD-10-CM codes, often requiring <strong>Z00.6</strong>, <strong>modifier Q0</strong> for investigational clinical services, and a clinical trial identifier. Examples illustrate coding for Abbott Aveir and Medtronic Micra leadless pacemakers, EV-ICD placement, wireless CRT systems, CCM implantation, Barostim, and CardioMEMS implantation.

The deck also highlights important coverage policies, especially CMS Coverage with Evidence Development (CED) rules, and notes that clinical trial participation and documentation must be verified carefully. The presentation ends with a reimbursement disclaimer stating that coding responsibility remains with the provider and that the material is for reference only.

Keywords

Category III CPT codes

electrophysiology coding

device technologies

clinical trial billing

leadless pacemakers

EV-ICD

intracardiac ischemia monitoring

wireless left ventricular pacing

cardiac contractility modulation

baroreflex activation therapy