CPT 0632T: Ultrasound-Guided Pulmonary Artery Nerve Interruption

CPT code 0632T identifies a minimally invasive, ultrasound-guided procedure to interrupt the pulmonary artery nerve supply, including required imaging guidance and right heart catheterization. This emerging interventional cardiology service is notable for its potential role in treating pulmonary vascular or autonomic conditions and for the procedural complexity and resource use it entails. Nationally, accurate coding and coverage determination for this procedure affect hospital outpatient workflows, payer-provider contract terms, and patient access to specialized interventions.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication outlines coverage and reimbursement considerations across major national payers, highlights benchmarking elements for hospital and ambulatory surgical settings, and summarizes the clinical and procedural context necessary for billing and authorization processes.

Readers will learn the clinical scope and included services for CPT code 0632T, typical sites of service, and what elements are commonly bundled into the code. The report also examines payer coverage patterns, common administrative issues affecting claim adjudication, and key metrics used in benchmarking utilization and reimbursement. Data not available in the input is clearly noted where applicable.

Billing Code Overview

CPT code 0632T describes a minimally invasive, ultrasound-guided procedure that interrupts the pulmonary artery nerve supply. The service includes the imaging guidance and right heart catheterization necessary to complete the intervention.

Service type: Minimally invasive endovascular/interventional cardiology procedure
Typical site of service: Hospital outpatient department or specialized interventional suite

Clinical Context

A typical patient is an adult with symptomatic pulmonary arterial hypertension (PAH) or chronic thromboembolic pulmonary hypertension (CTEPH) who remains symptomatic despite optimized medical therapy (e.g., prostacyclins, endothelin receptor antagonists, phosphodiesterase-5 inhibitors) and is evaluated for interventional options. The patient presents with progressive exertional dyspnea, exercise intolerance and right-sided heart strain on imaging and echocardiography. Right heart catheterization confirms elevated pulmonary artery pressures and pulmonary vascular resistance. After multidisciplinary team review (pulmonology, cardiology, interventional cardiology / interventional pulmonology, and anesthesia), the patient is scheduled for a minimally invasive ultrasound-guided pulmonary artery denervation procedure.

Workflow summary:

Pre-procedure: Informed consent, review of prior imaging, optimization of anticoagulation, baseline labs, and transthoracic echocardiogram. Anesthesia evaluation (typically monitored anesthesia care or general anesthesia) and vascular access planning are completed.
Intra-procedure: The provider obtains venous access, performs right heart catheterization for hemodynamic measurements, uses fluoroscopic and/or intravascular ultrasound guidance to position the catheter in the pulmonary artery, and delivers targeted ultrasound energy to interrupt pulmonary artery nerve fibers. Imaging guidance and hemodynamic monitoring are integral and are included in the service.
Post-procedure: The patient is observed in a monitored setting for hemodynamic stability, access-site management, and potential complications (bleeding, arrhythmia, pulmonary artery injury). Follow-up includes repeat hemodynamics and clinical reassessment to gauge symptomatic and functional improvement.

Coding Specifications

Taxonomy Code	Specialty	Notes
`3336P0800X`	Interventional Cardiology	Frequently involved in pulmonary vascular interventions and right heart catheterization.
`207RH0000X`	Interventional Pulmonology	Performs catheter-based pulmonary artery procedures in some centers.
`207RP1001X`	Pulmonology	Provides longitudinal management of pulmonary hypertension and collaborates in patient selection.
`207RC0000X`	Cardiology	Manages heart failure and pulmonary hypertension co-morbidities and performs invasive hemodynamic assessment.
`363L00000X`	Vascular Surgery	May be involved for access-site management or complex vascular considerations.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`I27.0`	Primary pulmonary hypertension	Classic indication for pulmonary artery denervation when refractory to medical therapy.
`I27.2`	Other secondary pulmonary hypertension	Includes pulmonary hypertension due to lung disease or hypoxia; may be considered when symptoms persist despite treatment.
`I27.20`	Pulmonary hypertension, unspecified	Used when precise etiology is not yet determined but pulmonary hypertension is present and intervention is being considered.
`I27.21`	Secondary pulmonary arterial hypertension	Relevant for cases with identifiable causes leading to elevated pulmonary pressures.
`I26.99`	Other pulmonary embolism without acute cor pulmonale	Chronic thromboembolic disease leading to pulmonary hypertension may prompt interventional evaluation.
`J84.10`	Pulmonary fibrosis, unspecified	Chronic lung disease causing pulmonary hypertension and consideration for advanced interventions.
`I50.9`	Heart failure, unspecified	Right-sided heart failure symptoms often coexist and factor into procedural decision-making.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`93451`	Right heart catheterization including measurement(s) when performed (with or without provocation)	Performed before or as part of the procedure to obtain baseline hemodynamics and guide therapy; often billed when separate from the included diagnostic component.
`76937`	Ultrasound guidance for vascular access (e.g., for central venous access)	Used for venous access placement for right heart catheterization and device introduction.
`93306`	Echocardiography, transthoracic, real-time with image documentation, complete	Used pre- and post-procedure to assess right heart size and function; not part of the denervation procedure itself.
`99291`	Critical care, evaluation and management of the critically ill or critically injured patient; first 30-74 minutes	May be reported if the patient requires critical care services related to hemodynamic instability associated with the procedure.
`94010`	Respiratory flow rate and spirometry	May be used for pulmonary function assessment in pre-procedure evaluation when clinically indicated.
`99100`	Anesthesia for patient of extreme age, under 1 year or over 70 years of age, requiring special monitoring	Applicable when anesthesia-related considerations meet specific age and monitoring criteria during the procedure.

`22`	Increased procedural services	When work required is substantially greater than typically required (document rationale).
`23`	Unusual anesthesia	When general anesthesia is medically necessary and not typical for the procedure.
`51`	Multiple procedures	When multiple unrelated procedures are submitted on the same day by the same provider.
`52`	Reduced services	When the procedure is partially reduced or not completed as originally planned.
`53`	Discontinued procedure	When the procedure is terminated due to extenuating circumstances or patient safety.
`62`	Two surgeons	When two surgeons work together as primary surgeons performing distinct portions of a complex procedure.
`73`	Discontinued outpatient prior to anesthesia	When the outpatient procedure is discontinued after the patient is taken to the procedure area but before anesthesia is administered.
`80`	Assistant surgeon	When an assistant surgeon is required and documented.
`81`	Minimum assistant surgeon	When a minimum assistant surgeon is documented as needed.
`82`	Assistant not available in facility	When assistant surgeon services are required but a qualified assistant is not available.

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Summary & Overview