Summary & Overview
CPT 0798T: Dual‑Chamber Leadless Pacemaker Extraction
CPT code 0798T designates percutaneous removal of a complete dual‑chamber leadless pacemaker system, a specialized cardiac extraction procedure that may be performed with imaging guidance. This procedure is relevant nationally as leadless pacemaker technologies and their lifecycle management become more common in electrophysiology practice. Payers and health systems track utilization of such device removal codes for clinical outcomes, device management, and payment policy development.
Key payers considered in this context include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical intent of the code, typical settings where the service is delivered, and the stakeholders likely to be involved in coverage and payment decisions. The publication outlines benchmarks and policy considerations relevant to this specialized procedural code, clinical context for device extraction, and coding considerations that affect billing and claims processing.
This summary provides actionable reference material for clinicians, coding professionals, and policy analysts seeking to understand how CPT code 0798T is used in practice and considered by major national payers.
Billing Code Overview
CPT code 0798T describes a procedure in which the provider uses a catheter to remove a complete dual–chamber leadless pacemaker system from the heart. The description notes that the provider may use imaging guidance during the procedure.
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Service type: Percutaneous transcatheter leadless pacemaker extraction
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Typical site of service: Hospital inpatient or outpatient cardiac catheterization laboratory or hybrid operating room
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult with a malfunctioning or infected leadless dual–chamber pacemaker system presenting for percutaneous extraction. Common indications include device infection, thrombus formation, device malfunction with loss of capture or sensing, or system upgrade requiring removal. The clinical workflow begins with preprocedural evaluation including history, focused cardiac exam, chest radiography, device interrogation, transthoracic or transesophageal echocardiography to assess attachment and thrombus, and review of anticoagulation status.
On the day of the procedure the patient is brought to a cardiac catheterization laboratory or hybrid operating room under conscious sedation or general anesthesia based on comorbidity and operator preference. Vascular access is obtained (typically femoral venous), fluoroscopic and/or intracardiac echocardiographic guidance is used, and a retrieval catheter/device is advanced to engage and capture the dual‑chamber leadless pacemaker components. The system is withdrawn through the sheath with careful hemodynamic and rhythm monitoring. Post‑procedure care includes monitoring for vascular complications, pericardial effusion or tamponade, arrhythmia, and device pocket or bloodstream infection if present. Device interrogation confirms removal; plans for re‑implantation or alternative pacing strategy are documented as clinically indicated.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services |