Summary & Overview
CPT 0644T: Endovascular Intracardiac Mass Removal with Aspiration and Reinfusion
CPT code 0644T represents an endovascular, catheter-directed suction thrombectomy or mass removal procedure within the heart that includes aspiration and reinfusion of blood. The code captures a complex, image-guided interventional cardiology service intended to remove or debulk intracardiac masses such as thrombus or other intravascular material via vascular access. Nationally, this procedure is relevant due to growing adoption of minimally invasive cardiac interventions and implications for perioperative management, device availability, and payer coverage policies.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of the clinical context for the service, typical sites of care, common billing modifiers, and payer considerations. The publication also summarizes available benchmarks where provided, highlights policy and coding considerations affecting reimbursement and claims processing, and outlines practical billing and documentation topics relevant to clinicians, coding professionals, and payer policy analysts.
Data not available in the input: associated taxonomies, ICD-10 diagnoses, related codes, and detailed payer-specific coverage rules. The report focuses on national implications and operational considerations for institutions and clinicians using CPT code 0644T.
Billing Code Overview
CPT code 0644T describes a catheter-based, percutaneous procedure in which a provider uses a catheter and suction device navigated through the blood vessels to completely or partially remove an intracardiac mass. During the procedure, the provider reinfuses aspirated blood back into the patient.
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Service type: Endovascular intracardiac mass removal with aspiration and reinfusion
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Typical site of service: Hospital inpatient or hospital outpatient interventional suite or cardiac catheterization laboratory
Clinical & Coding Specifications
Clinical Context
A typical patient is a 65-year-old with a history of atrial fibrillation and progressive dyspnea who presents with an intracardiac thrombus or organized intracardiac mass identified on transesophageal echocardiography (TEE) and cardiac CT. The interventional cardiology team schedules a percutaneous intracardiac aspiration thrombectomy using a catheter and suction device delivered via the venous system (commonly femoral or internal jugular access) to remove all or part of the mass. During the procedure, anticoagulation is managed per protocol and hemodynamics are continuously monitored; aspirated blood is filtered and reinfused to minimize blood loss and transfusion requirement. The workflow typically includes pre-procedure imaging review, informed consent documenting risks and alternatives, vascular access and catheter navigation under fluoroscopic and echocardiographic guidance, aspiration of the mass with concurrent return of filtered blood, post-procedure hemostasis and monitoring in a recovery or cardiac observation unit, and post-procedure imaging to confirm reduction or removal of the mass. Indications include large mobile thrombus with embolic risk, right-sided endocarditic vegetations when surgery is high risk, or obstructive intracardiac masses causing hemodynamic compromise.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier — standard primary procedure reporting | Use as the base reporting state when no circumstance modifier applies |