Summary & Overview
CPT 0803T: Removal and Replacement of Right Ventricular Leadless Pacemaker Component
CPT code 0803T represents a percutaneous procedure to remove and replace the right ventricular portion of a dual‑chamber leadless pacemaker system, typically performed with catheter techniques and possible imaging guidance. This code captures a specialized cardiac device intervention relevant to hospitals and cardiac catheterization facilities nationwide, reflecting advances in leadless pacing technology and device management. Key payers analyzed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will gain a concise understanding of what the code represents clinically, the typical site of service, and the payer landscape addressed in this publication. The report includes benchmarks related to utilization and payment where available, summaries of pertinent policy and coverage considerations from major payers, and clinical context about the procedural intent and care setting. If specific data elements are unavailable in the source input, the publication will note "Data not available in the input." This summary is written for a national audience interested in clinical coding, hospital billing, and payer policy for advanced cardiac device procedures.
Billing Code Overview
CPT code 0803T describes a procedure in which the provider uses a catheter to remove and replace the right ventricular component of a complete dual–chamber leadless pacemaker system. The procedure may be performed with imaging guidance.
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Service type: Percutaneous cardiac device component revision/replacement
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Typical site of service: Hospital catheterization laboratory or specialized cardiac procedural suite
Clinical & Coding Specifications
Clinical Context
A 72-year-old patient with a previously implanted complete dual‑chamber leadless pacemaker system presents with malfunction of the right ventricular component, documented by device interrogation showing loss of capture and abnormal sensing. The patient reports dizziness and presyncope. Imaging (fluoroscopy and transthoracic echocardiography as needed) confirms the position of the leadless components. The electrophysiology team schedules a catheter-based procedure in a cardiac catheterization laboratory or hybrid operating room to remove and replace the right ventricular component. The workflow includes pre-procedure device interrogation and programming, informed consent, moderate sedation or general anesthesia per anesthesia evaluation, vascular access via femoral venous approach, fluoroscopic and/or intracardiac echocardiographic guidance to engage and extract the malfunctioning right ventricular capsule, immediate re-implantation of a new right ventricular component to restore dual‑chamber pacing functionality, post-implant device testing, hemostasis, and short observational monitoring prior to discharge or transition to inpatient care if complications occur.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased Procedural Services | Use when the work required to remove and replace the right ventricular component is substantially greater than usual due to complexity (extensive adhesions, difficult extraction). |