Summary & Overview
CPT 0917T: Transvenous Lead Implantation for Cardiac Contractility Modulation–Defibrillation
CPT code 0917T represents implantation of a single transvenous lead for a cardiac contractility modulation–defibrillation system, a specialized device procedure that combines contractility modulation therapy with defibrillation capability. This code captures the operative placement of a transvenous pacing/defibrillation lead under fluoroscopic guidance and includes intraoperative evaluation and programming to ensure device function. Nationally, the procedure is clinically significant for patients with advanced heart failure or arrhythmia risk who may benefit from contractility modulation plus defibrillation protection.
Key payers included in the coverage discussion are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise orientation to the code, its clinical setting, and the typical site of service, followed by benchmarks and payer coverage considerations where available. The publication covers coding context, common modifiers, and operational notes relevant to billing and hospital procedure workflows. It also highlights clinical context for device implantation and what documentation elements typically underpin use of this code.
Data not available in the input for associated taxonomies, specific ICD-10 diagnoses, related codes, and service-line financial benchmarks is noted where relevant; the piece focuses on the code definition, service context, payer scope, and actionable coding and documentation topics for national audiences.
Billing Code Overview
CPT code 0917T describes implantation of a single transvenous lead for a cardiac contractility modulation–defibrillation system. The procedure involves fluoroscopic guidance to place a transvenous lead for either pacing or defibrillation, followed by intraoperative evaluation and device programming to confirm appropriate sensing, capture, and defibrillation capabilities.
-
Service type: Implantation of a transvenous cardiac lead for a combined contractility modulation and defibrillation system
-
Typical site of service: Hospital-based cardiac electrophysiology or cardiac device implantation suite using fluoroscopy
Clinical & Coding Specifications
Clinical Context
A typical patient is a 60–75-year-old with symptomatic heart failure with reduced ejection fraction who remains symptomatic despite guideline-directed medical therapy. The patient has exertional dyspnea (NYHA class II–III), reduced left ventricular ejection fraction, and preserved conduction that makes them a candidate for cardiac contractility modulation (CCM) therapy. The cardiology team schedules implantation of a single transvenous lead for a CCM–defibrillation system. The workflow includes pre-procedure evaluation (history and physical, updated medication list, review of prior electrocardiography and echocardiography), informed consent, anticoagulation management, and peri-procedural antibiotic prophylaxis per facility protocol.
In the electrophysiology lab or hybrid OR under fluoroscopic guidance, vascular access is obtained (typically via subclavian or cephalic vein). The provider advances and positions a single transvenous lead into the target right ventricular septal region using fluoroscopy, confirms electrical parameters, secures the lead, and connects and evaluates the CCM–defibrillation system. Device programming and intraoperative testing verify sensing, capture thresholds, and defibrillation readiness if applicable. Post-procedure monitoring occurs in the recovery area or cardiac observation unit with wound checks, device interrogation, chest radiograph as indicated, and discharge instructions including activity restrictions and follow-up device clinic visit for ongoing programming and surveillance.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when the procedure required substantially greater effort or complexity than typical and documentation supports unusual work. |
51 | Multiple procedures | Use when other distinct procedures are billed the same day; applies per payer rules for multiple-procedure reductions. |
52 | Reduced services | Use when the procedure is partially reduced or not completed as planned but still performed. |
53 | Discontinued procedure | Use when the procedure is terminated due to patient-related or intraoperative circumstances prior to completion. |
62 | Two surgeons | Use when two surgeons work together as primary surgeons during a portion of the procedure and payer allows payment to two surgeons. |
66 | Surgical team (major) | Use when a surgical team (multiple surgeons with defined roles) performs the procedure in a high-complexity setting. |
78 | Return to OR for related procedure during postoperative period | Use when a related procedure for a complication of the implant is performed in the global period. |
80 | Assistant surgeon | Use when an assistant surgeon is required and documentation supports the need. |
81 | Minimum assistant surgeon | Use when a minimal assistant role is documented and allowed by payer policy. |
82 | Assistant surgeon (when qualified resident not available) | Use when a qualified resident is not available and an assistant is required. |
AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | Use when an allowed non-physician assistant performs an assistant role during the procedure. |
QK | Medical direction of two, three, or four concurrent anesthesia procedures (deleted for some payers) | Use only if anesthesia medical direction applies and payer accepts modifier for the anesthesia service. |
QX | CRNA service with medical direction by physician | Use to denote services furnished by a CRNA when a physician medically directs. |
QY | Medical direction of one certified registered nurse anesthetist by an anesthesiologist | Use when applicable for anesthesia billing. |
TG | Via transluminal thoracic endovascular approach | Use only if a transluminal thoracic endovascular approach is applicable and payer recognizes this modifier. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 207RP1000X | Cardiovascular Disease (Interventional Cardiology) | Interventional cardiologists may participate in device implantation and lead placement in hybrid settings. |
| 207RT0000X | Cardiac Electrophysiology | Electrophysiologists commonly perform transvenous lead implantation and device programming. |
| 208D00000X | Thoracic and Cardiac Surgery | Cardiac surgeons may be involved in complex device implantations or complications requiring surgical intervention. |
| 363A00000X | Nurse Practitioner (Cardiology) | NPs provide peri-procedural care, device clinic follow-up, and programming under supervising agreements. |
| 163WL0500X | Physician Assistant (Cardiology) | PAs assist in procedural care, pre- and post-procedure management, and device clinic services. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
I50.22 | Chronic systolic (congestive) heart failure | Common indication for CCM therapy in patients with reduced ejection fraction and persistent symptoms. |
I50.32 | Chronic combined systolic and diastolic heart failure | Reflects mixed ventricular dysfunction where CCM may be considered to improve contractility. |
I50.3 | Diastolic (congestive) heart failure | Some patients with heart failure symptoms and preserved ejection fraction may be evaluated for device-based therapies in investigational contexts. |
I50.9 | Heart failure, unspecified | Used when heart failure is present and specific subtype not documented; indicates clinical context for device implantation. |
I25.10 | Atherosclerotic heart disease of native coronary artery without angina pectoris | Ischemic cardiomyopathy is a common underlying etiology for reduced ejection fraction requiring device therapy. |
I42.8 | Other cardiomyopathies | Nonischemic cardiomyopathies are common indications for device-based therapies including CCM evaluation. |
R00.2 | Palpitations | Symptom that may prompt electrophysiology evaluation and consideration of device therapy in the broader clinical workup. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
33208 | Insertion of implantable cardioverter-defibrillator, single lead, transvenous | May be performed in patients requiring defibrillation capability; shares transvenous lead techniques and postoperative care. |
33207 | Insertion of permanent pacemaker, single lead, transvenous | Similar lead insertion technique when pacing function is needed; relevant for patients who require pacing rather than defibrillation. |
33216 | Insertion or replacement of permanent pacemaker lead, transvenous, single lead | Represents lead placement or revision procedures that may be performed concurrently or in separate encounters. |
93279 | Interrogation device evaluation (in-person) with program or reprogramming when performed | Used for intraoperative and post-implant device interrogation and programming for CCM–defibrillation systems. |
71020 | Radiologic examination, chest; single view, frontal | May be used post-procedure to document lead position and exclude pneumothorax when clinically indicated. |