CPT 0675T: Laparoscopic Diaphragmatic Stimulation Lead Implantation

CPT code 0675T covers the laparoscopic insertion or replacement of the first lead for a synchronized diaphragmatic stimulation system and connection of that lead to an existing pulse generator. This procedure targets patients with heart failure by delivering diaphragmatic stimulation synchronized to cardiac activity, a technology intended to support cardiac function as an adjunctive therapy. Nationally, adoption of device-based cardiac neuromodulation has implications for surgical services, implantable device management, and post-procedure care pathways.

Key payers in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of the clinical purpose of the procedure, typical sites of service, and the service type, along with coverage and reimbursement context where available. The publication summarizes benchmark considerations, common billing modifiers, and coding interactions relevant to implant and lead management. It also provides clinical context for why synchronized diaphragmatic stimulation may be used in heart failure patients and outlines documentation and billing issues commonly encountered with device implantation and lead connections.

This content is written for a national audience and focuses on the code's clinical and billing significance, helping payers, providers, and coding professionals understand the role of CPT code 0675T in device-based heart failure care.

Billing Code Overview

CPT code 0675T describes a laparoscopic procedure to insert or replace the first lead of a synchronized diaphragmatic stimulation system and to connect that lead to an existing pulse generator. The system is designed to provide synchronized diaphragmatic stimulation intended to support cardiac function in patients with heart failure.

Service Type: Surgical implantation/lead replacement for a cardiac neuromodulation device

Typical Site of Service: Hospital operating room or ambulatory surgery center (laparoscopic surgery setting)

Data not available in the input.

Clinical Context

A 68-year-old patient with New York Heart Association (NYHA) class III–IV heart failure and reduced ejection fraction presents for implantation of a synchronized diaphragmatic stimulation lead to augment cardiac function. The patient previously underwent implantation of a compatible pulse generator for the diaphragmatic stimulation system; current symptoms include exertional dyspnea and refractory fatigue despite guideline-directed medical therapy. Cardiac imaging and device interrogation confirm appropriate candidacy for lead placement.

Pre-procedure workflow includes preoperative evaluation by cardiology and cardiothoracic surgery or electrophysiology, informed consent, review of prior device records, and perioperative anesthesia assessment. The procedure is performed in an operating room or interventional suite under general anesthesia with laparoscopic access to the diaphragm. The provider creates trocar access, visualizes the diaphragm laparoscopically, inserts or replaces the first lead of the synchronized diaphragmatic stimulation system, tunnels and secures the lead, and connects it to the existing pulse generator. Intraoperative testing confirms appropriate lead function and diaphragmatic capture. Postoperative workflow includes recovery, device programming by the electrophysiology team, chest imaging if indicated, and discharge planning with device follow-up and heart failure clinic coordination.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services

Taxonomy Code	Specialty	Notes
207RC0000X	Cardiothoracic Surgery	Frequently performs thoracic and diaphragmatic-related surgical procedures and lead placement.
207RP1001X	Cardiac Electrophysiology	Oversees device implantation and lead connection, device programming, and testing.
207Q00000X	Cardiology	Referring and co-managing specialty for heart failure and device candidacy evaluation.
2086S0130X	General Surgery	May perform laparoscopic abdominal access, lead insertion, and diaphragmatic visualization.
363LA2200X	Anesthesiology	Provides general anesthesia and intraoperative physiologic management.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`I50.22`	Chronic systolic (congestive) heart failure	Common indication: reduced ejection fraction heart failure for which synchronized diaphragmatic stimulation is intended to augment cardiac function.
`I50.23`	Acute on chronic systolic (congestive) heart failure	Relevant when patients present with acute decompensation on chronic systolic heart failure requiring device-based therapies.
`I50.32`	Chronic diastolic (congestive) heart failure	Diaphragmatic stimulation may be considered in select patients with heart failure symptoms refractory to medical therapy.
`I50.33`	Acute on chronic diastolic (congestive) heart failure	Relevant for perioperative risk and optimization when device therapy is considered during decompensation episodes.
`I50.9`	Heart failure, unspecified	Used when heart failure is documented but specific subtype is not yet determined; maps to device candidacy documentation.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`33418`	Insertion or replacement of pacing lead, epicardial, single lead, with or without pulse generator	May be used when epicardial or non-laparoscopic lead approaches are required or in hybrid procedures.
`33206`	Insertion of new or replacement of permanent pacemaker lead, transvenous, single lead, atrial or ventricular	Related when concurrent transvenous pacing leads or system evaluation occur in the same patient.
`43774`	Laparoscopy, surgical, diaphragmatic repair or procedure	Represents laparoscopic access and work on the diaphragm; used when additional diaphragmatic surgical work is performed beyond lead placement.
`95920`	Electronic analysis of implanted neurostimulator pulse generator/transmitter with intraoperative or subsequent programming	Used for intraoperative or immediate postoperative device testing and programming of the diaphragmatic stimulation system.
`95970`	Electronic analysis of implanted neurostimulator pulse generator/transmitter with programming, initial or subsequent	Used for device interrogation and programming during device follow-up or in the immediate perioperative period.

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Summary & Overview