Cardiology Question for the Week of September 11, 2017

Question:

What code should we report for the insertion of a percutaneous ventricular-assist device such as the Impella device?

Answer:

The following four codes exist for the insertion, removal and repositioning of a percutaneously inserted ventricular assist device (pVAD):

33990

Insertion of ventricular assist device, percutaneous including radiological supervision and interpretation; arterial access only

33991

both arterial and venous access, with transseptal puncture

33992

Removal of percutaneous ventricular assist device at separate and distinct session from insertion

33993

Repositioning of percutaneous ventricular assist device with imaging guidance at separate and distinct session from insertion

Code 33990 is assigned for devices such as Impella 2.5 and Impella 5.0, which require arterial access only. Insertion of the TandemHeart and other devices that require both arterial and venous access would be coded 33991. Repositioning of either type of device at a separate session would be coded 33993. Removal of either type of device at a separate session would be coded 33992.

Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.

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Cardiology Question for the Week of September 11, 2017

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