Summary & Overview
CPT 0679T: Laparoscopic Removal of Synchronized Diaphragmatic Stimulation Leads
CPT code 0679T identifies a laparoscopic procedure to remove one or more leads from a synchronized diaphragmatic stimulation system used to support cardiac function in patients with heart failure. As implantable cardiac and neuromodulation technologies expand, this code captures a specific extraction service tied to devices intended to improve cardiac performance through diaphragmatic pacing. National attention to device management and lead extraction arises from clinical safety, device longevity, and coverage policy considerations.
Key payers covered include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise view of what this code represents clinically and operationally, plus the payer landscape relevant to coverage and reimbursement discussions.
This publication summarizes the clinical context for the procedure, the typical sites where it is performed (hospital OR and ambulatory surgical centers), and the common billing modifiers associated with complex surgical services. It also outlines which payers are included in benchmarking and policy review. Where specific data elements were not provided in the source input, the text notes the absence of that information. The piece is intended to inform coding professionals, revenue cycle managers, and policy analysts about the role of 0679T in device management workflows, coding practices, and payer interactions.
Billing Code Overview
CPT code 0679T describes a laparoscopic procedure to remove one or more leads of a synchronized diaphragmatic stimulation system. The synchronized diaphragmatic stimulation system is intended to support cardiac function in patients with heart failure by providing diaphragmatic pacing synchronized to the cardiac cycle.
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Service type: Lead removal for implantable synchronized diaphragmatic stimulation system (laparoscopic approach)
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Typical site of service: Hospital operating room or ambulatory surgical center using laparoscopic surgical equipment
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 68-year-old male with ischemic cardiomyopathy and chronic heart failure (left ventricular ejection fraction 30%) has a previously implanted synchronized diaphragmatic stimulation (SDS) system with transvenous or laparoscopically placed leads to the diaphragm. He presents with recurrent device-related pain and lead malfunction documented by device interrogation, loss of diaphragmatic capture, and intermittent diaphragmatic stimulation causing significant discomfort and reduced quality of life. Imaging and device evaluation confirm a nonfunctional lead requiring removal.
The clinical workflow begins with preoperative cardiac and anesthesia assessment, device interrogation and imaging (chest radiograph/fluoroscopy), informed consent discussing risks of lead extraction, and perioperative antibiotic prophylaxis. The patient undergoes general anesthesia in an operating room or procedure suite capable of laparoscopic and cardiac support. Using a laparoscopic approach, the surgeon identifies and removes one or more SDS leads from the diaphragm and subcutaneous system components as needed. Intraoperative monitoring includes continuous ECG, invasive or noninvasive blood pressure, and device telemetry. Postoperatively, the patient is observed for cardiopulmonary stability, monitored for bleeding, infection, or diaphragmatic dysfunction, and has device programming or reimplantation planning as indicated. Typical recovery includes short inpatient observation or same-day discharge depending on comorbidity and procedure complexity.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 |