2025 CPT code 0544T

Percutaneous placement of an adjustable annulus device to treat mitral regurgitation.

Follow CPT guidelines for Category III codes.Always check with the payer for coverage and reimbursement policies, as Category III codes are temporary and may not be covered by all payers.

Modifiers may be applicable depending on the circumstances of the procedure and services provided.Consult official coding guidelines for modifier usage rules.

The procedure is medically necessary when a patient has symptomatic or asymptomatic mitral regurgitation that is deemed severe enough to warrant intervention, and when the patient is not a suitable candidate for open-heart surgery due to high surgical risk or comorbidities. Documentation should support the diagnosis and demonstrate the medical necessity of this less invasive procedure.

A cardiologist or cardiac surgeon performs this procedure, requiring expertise in transcatheter interventions and echocardiography.The procedure may involve other professionals such as anesthesiologists, radiology technicians, and nurses.

IMPORTANT For a similar procedure on the tricuspid valve, see code 0545T.Cardiac catheterization services may be reported separately under certain conditions.Cardiopulmonary bypass (33367-33369), ventricular assist device use (33990-33993), or balloon pump insertion (33967, 33970, 33973) may also be separately reported if performed.

In simple words: The doctor inserts a small device into the heart through a small incision in the leg to repair a leaky mitral valve, a valve between two chambers of the heart.This is done without stopping the heart, using imaging guidance.

This procedure involves the percutaneous transcatheter delivery of an adjustable annulus implant to reconstruct and tighten the dilated annulus of the mitral valve.The device is inserted via a catheter through the skin and across the interatrial septum. Fluoroscopic and transesophageal echocardiographic (TEE) guidance are typically used. The procedure is performed on a beating heart without cardiopulmonary bypass (CPB), although standby CPB may be available.The implant is anchored to the annular tissue, and its size is adjusted to control mitral regurgitation.Temporary pacemaker insertion may be necessary.

Example 1: A 70-year-old patient with severe mitral regurgitation is a poor surgical candidate due to other health conditions.This procedure offers a less invasive approach to treating their valve disease., A 65-year-old patient with moderate mitral regurgitation experiences worsening symptoms despite medical management.The procedure is chosen as a minimally invasive alternative to open-heart surgery., A 55-year-old patient with moderate mitral regurgitation requires urgent intervention due to rapidly deteriorating heart function. The procedure is performed emergently with additional preparation and assessment.

Detailed patient history and physical examination, echocardiography reports (pre and post procedure), fluoroscopy images, catheterization data, hemodynamic measurements, and any complications encountered.

** This code is a Category III code, indicating that it's for an emerging technology or service.Reimbursement policies may vary among payers.Accurate documentation is crucial for appropriate coding and reimbursement. Always consult the most current CPT codebook and payer guidelines for the most up-to-date information.

  • Payment Status: Active (but may vary by payer)
  • Modifier TC rule: TC modifier may or may not apply depending on the extent of the procedure and services provided. Consult official coding guidelines for modifier usage rules.
  • Specialties:Cardiology, Cardiac Surgery
  • Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center
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