Summary & Overview
CPT 0805T: Percutaneous Femoral Vein Caval Valve Implantation
CPT code 0805T defines a percutaneous femoral vein approach for implanting prosthetic valves in the vena cava using a catheter. This emerging interventional vascular procedure addresses venous insufficiency or pathologies requiring caval valve replacement and is notable for its minimally invasive access to central venous structures. Nationally, the code is relevant as health systems and payers consider coverage, site-of-service appropriateness, and clinical pathways for complex venous interventions.
Key payers in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context, typical sites of service, and where this procedure fits within interventional vascular care. The publication summarizes available benchmarks, common billing practices, and policy considerations that affect reimbursement and utilization across major national payers. It also outlines coding nuances and operational implications for hospitals and ambulatory surgical centers.
The content is designed to help clinicians, billing professionals, and policy stakeholders understand the procedural intent of 0805T, common places of service, and the payer landscape relevant to adoption and coverage decisions. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 0805T describes a procedure in which the provider uses a percutaneous femoral vein approach to implant prosthetic valves in the vena cava using a catheter. This is a vascular interventional procedure performed through the femoral venous access, targeting the inferior or superior vena cava for placement of prosthetic caval valves.
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Service type: Percutaneous venous valve implantation via femoral vein catheterization
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Typical site of service: Hospital outpatient department or ambulatory surgical center where interventional vascular procedures are performed
Clinical & Coding Specifications
Clinical Context
A 78-year-old patient with severe symptomatic tricuspid regurgitation or vena caval insufficiency related to prior valve disease, right heart failure, or recurrent venous congestion presents for percutaneous implantation of prosthetic valves in the vena cava. The interventional cardiology team evaluates the patient in the outpatient setting with transthoracic echocardiography, transesophageal echocardiography as needed, and computed tomography venography to plan valve sizing and delivery. On the day of service the patient is admitted to an interventional suite or hybrid operating room under monitored anesthesia care or general anesthesia. Vascular access is obtained via the common femoral vein using ultrasound guidance. A transcatheter delivery system is advanced through the femoral venous system to the target location in the inferior vena cava or superior vena cava. Prosthetic caval valve(s) are deployed under fluoroscopic and echocardiographic guidance. Hemostasis is achieved at the femoral access site; the patient is recovered in the postanesthesia care unit and observed for access complications, arrhythmia, bleeding, or right heart failure exacerbation prior to discharge or transfer to an inpatient bed.
Typical site of service: Hospital outpatient interventional radiology or cardiac catheterization laboratory, hybrid operating room, or inpatient operating room for higher-risk patients.
Typical patient scenario: Elderly patient with right-sided heart failure symptoms and hepatic congestion, refractory edema, or persistent ascites due to severe regurgitant flow into the vena cava who is deemed a candidate for percutaneous caval valve implantation after multidisciplinary heart team review.
Coding Specifications
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