Summary & Overview
CPT 0544T: Percutaneous Adjustable Mitral Annulus Reconstruction
CPT code 0544T represents a novel percutaneous transseptal procedure to implant an adjustable annulus device for reconstruction and tightening of a dilated mitral valve annulus to treat mitral regurgitation. As structural heart interventions expand, this code captures a device-based, minimally invasive alternative to open surgical annuloplasty and is relevant for cardiac specialists, payers, and hospitals considering coverage, site-of-service planning, and coding guidance.
Key payers in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication outlines clinical context for the procedure, typical settings where it is performed, and common billing considerations. Readers will find national-level benchmarks where available, summaries of payer coverage considerations, and a concise review of the clinical purpose and procedural intent for CPT code 0544T.
This summary is intended to inform coding teams, revenue cycle managers, and clinical program leads about the code’s purpose and where it fits within structural heart service lines. Data not available in the input is noted where applicable in detailed sections that follow.
Billing Code Overview
CPT code 0544T describes a percutaneous, catheter-delivered procedure in which the provider inserts an adjustable annulus device across the interatrial septum to reconstruct and tighten a dilated mitral valve annulus to treat mitral regurgitation. The service involves transseptal access and placement of an implanted or implantable device to reduce valve regurgitation by restoring annular geometry.
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Service type: Percutaneous transseptal mitral annulus reconstruction using an adjustable annulus device
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Typical site of service: Hospital inpatient or outpatient cardiac catheterization/interventional cardiology suite or hybrid operating room
Clinical & Coding Specifications
Clinical Context
A 78-year-old patient with symptomatic primary degenerative mitral regurgitation and left ventricular dilation is referred for a transcatheter mitral annuloplasty using an adjustable annulus device. The patient has progressive exertional dyspnea (NYHA class II–III), evidence of significant mitral regurgitation on transthoracic and transesophageal echocardiography, and is judged to be at increased surgical risk due to comorbidities (for example, chronic obstructive pulmonary disease and prior coronary artery bypass grafting). After heart team review, the patient is scheduled for a percutaneous, transseptal approach.
Pre-procedure workflow includes outpatient cardiology evaluation, echocardiography (transthoracic and transesophageal), cardiac catheterization as indicated, informed consent, and pre-anesthesia assessment. On the day of service, the patient undergoes general anesthesia or monitored anesthesia care, vascular access is obtained (typically femoral venous), and a transseptal puncture is performed to access the left atrium. Under fluoroscopic and echocardiographic guidance, the operator advances a catheter across the interatrial septum and deploys the adjustable annulus device to reconstruct and reduce the dilated mitral annulus, aiming to reduce leaflet malcoaptation and mitral regurgitation. Intraprocedural transesophageal echocardiography documents device position and immediate regurgitation improvement. Post-procedure, the patient is recovered in a monitored setting with post-procedure echocardiography, anticoagulation management as indicated, and discharge planning with follow-up cardiology and echocardiography to assess device function and residual regurgitation.
Coding Specifications
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