CPT 0494T: Surgical Preparation and Perfusion of Cadaver Donor Lung(s) - OpenPayer

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Summary & Overview

CPT 0494T: Surgical Preparation and Perfusion of Cadaver Donor Lung(s)

CPT code 0494T denotes the surgical preparation and preservation of cadaver donor lung(s), including attachment to an organ perfusion system and removal from that system for implantation. This code captures an advanced component of organ procurement that directly affects transplant viability and outcomes. Nationally, recognition of this procedure-level service is important for transplant centers, payers, and hospital billing operations as ex vivo lung perfusion and coordinated donor management gain wider clinical uptake.

Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication provides a concise overview of coverage landscape and billing considerations for these major national payers.

Readers will learn the clinical context of the service, typical settings where the procedure occurs, and the elements that this CPT code is intended to represent. The piece also summarizes expected benchmarking topics and policy-relevant issues that commonly arise with organ preservation and procurement codes, including coding specificity, payer coverage patterns, and areas where further payer guidance is often sought. Data not available in the input will be noted where relevant.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare0494TCPTorgan procurementlung transplantationex vivo perfusionsurgical preparationtransplant billinghospital servicesoperative procedure

Billing Code Overview

CPT code 0494T describes the surgical preparation and preservation of cadaver donor lung(s), including attaching the lung to an organ perfusion system and removal from the system for implantation. The service covers intraoperative and immediate pre-implant handling intended to maintain organ viability for transplantation.

Service type: Surgical organ procurement and perfusion management
Typical site of service: Hospital operating room and associated organ donor recovery and preparation areas; may include specialized organ preservation suites where ex vivo perfusion systems are used

Clinical & Coding Specifications

Clinical Context

A typical patient scenario involves a deceased organ donor whose lungs are procured for transplantation. The donor is managed in the hospital’s organ procurement pathway; following determination of death and authorization for donation, the thoracic procurement team surgically prepares the donor lungs in the operating room or donor procurement suite. The clinical workflow includes ante-mortem and peri-mortem donor management (hemodynamic stabilization, ventilator optimization, infectious screening), intraoperative lung explantation, attachment of the explanted lung(s) to a portable organ perfusion and/or ex vivo lung perfusion (EVLP) system for preservation and assessment, and later removal from the perfusion system for transport or direct implantation. The procedure coded by 0494T documents the surgical preparation and preservation of cadaver donor lung(s), including attaching the lung to an organ perfusion system and its removal from the system for implantation.

Key participants include thoracic transplant surgeons, cardiothoracic surgical assistants, transplant coordinators, perfusionists/EVLP technologists, organ procurement organization staff, and operating room nursing. Typical site of service is the hospital operating room or dedicated organ procurement facility. Common clinical indications include donation after brain death (DBD) or donation after circulatory death (DCD) where lungs are recovered for planned transplantation into one or more recipients. The service facilitates organ viability assessment, preservation, and coordination for subsequent implantation.

Coding Specifications

Modifier	Description	When to Use

Taxonomy Code	Specialty	Notes
208U00000X	Thoracic Surgery	Primary specialty performing lung procurement and preparation for transplantation.
207P00000X	Cardiothoracic Surgery	Surgeons with combined cardiac/thoracic expertise who perform donor lung explantation and preparation.
1744P0800X	Transplant Surgery	Surgeons specialized in organ procurement and transplant coordination involved in lung recovery and preservation.
163W00000X	Perfusionist	Personnel who operate ex vivo lung perfusion systems and maintain organ perfusion parameters.
363L00000X	Nurse Transplant Coordinator	Clinical coordination of donor management, logistics, and documentation for procurement.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`Z52.0`	Organ donor	Indicates an individual is a donor; primary administrative diagnosis for cadaveric organ procurement and directly relevant to `0494T`.
`Z52.1`	Bone marrow donor	Not directly related to lung procurement but used in donor coding sets when multiple donations occur; included for completeness in donor classification.
`Z99.89`	Dependence on other enabling machines and devices, not elsewhere classified	May be used when donor required ventilatory support prior to procurement; relevant to donor management and lung suitability.
`R09.2`	Respiratory arrest	May describe terminal respiratory events leading to donor status; context for procurement timing.
`I69.398`	Other sequelae of other cerebrovascular disease	Common antecedent for brain death leading to organ donation; appears in donor history and impacts lung acceptance decisions.
`S06.5X9A`	Traumatic subdural hemorrhage with loss of consciousness, initial encounter	Example traumatic cause of brain death resulting in organ donation; relevant in donor clinical history affecting organ viability.
`A41.9`	Sepsis, unspecified organism	Infection in the donor can impact organ suitability; documentation needed when assessing lungs for transplantation.
`J96.00`	Acute respiratory failure, unspecified whether with hypoxia or hypercapnia	Donor respiratory failure state that affects lung quality and may necessitate EVLP and aggressive preservation documented by `0494T`.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`32663`	Thoracotomy with removal of lung and transplantation procedures (example: complex lung retrieval codes vary)	Performed when simultaneous open chest retrieval is required prior to lung preparation and attachment to perfusion systems; may precede `0494T`.
`01996`	Organ procurement from cadaver donor (thoracic organ procurement)	Billed for the overall organ procurement operation; `0494T` may represent the specific preparation/preservation portion of lung procurement within the broader procurement episode.
`33945`	Open implantation of heart-lung block or bilateral lung transplantation (example transplant implantation code)	Represents implantation of donor lung(s) into the recipient; occurs after preservation and transport steps coded by `0494T`.
`99199`	Unlisted anesthesia procedure (used for specialized perfusion/anesthesia services)	May be used for anesthetic services specific to multi-organ procurement when no CPT anesthesia code precisely describes the service accompanying `0494T`.
`0192T`	Ex vivo lung perfusion (EVLP) for assessment and reconditioning (example technology/temporary codes vary)	Performed for organ assessment and reconditioning; closely related to the actions described in `0494T` when EVLP systems are used for preservation and assessment prior to implantation.