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    v1.0.28
    OpenPayerBilling CodesTemporary CodesHCPCS hcpcs-q0498-holster-ventricular-assist-device-replacement
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    HCPCS Level II Q0498: Holster for Ventricular Assist Device, Replacement Only

    HCPCS Level II code Q0498 describes a replacement holster designed for use with an electric or electric/pneumatic ventricular assist device; the service represents supply/device replacement for the holster and is typically billed when the durable medical equipment accessory is provided to a patient using a ventricular assist system, commonly supplied in inpatient or home medical equipment settings.

    For related coverage guidance, see recent payer policy updates: B-Hemolytic Streptococcus Testing, Human Immunodeficiency Virus (HIV) — Coverage Criteria for Testing and Resistance Assays, Hepatitis Testing (A, B, C, D) Coverage Criteria.

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    Clinical & Coding Specifications

    Clinical Context

    A patient with an implanted electric or electric/pneumatic ventricular assist device (VAD) presents for replacement of a worn or damaged external holster used to secure the controller or power components. Typical patients are adults with advanced heart failure supported by a left, right, or biventricular VAD who attend an outpatient durable medical equipment (DME) clinic, VAD specialty clinic, or hospital ambulatory infusion/DME service. The clinical workflow includes verification of device model and compatibility, inspection of the existing holster for wear, confirmation of prescription/medical necessity by the VAD team or cardiac surgeon, DME order processing, sizing and selection of the replacement holster, patient education on securement and infection-avoidance, and documentation of serial/device identifiers. The service is typically billed by the DME supplier or hospital DME department and provided in an outpatient clinic, hospital outpatient department, or at bedside during an inpatient stay when patient mobility or device issues require immediate replacement. Relevant stakeholders include the treating cardiothoracic surgeon, VAD coordinator, DME supplier, and nursing staff who verify device fit and patient instruction.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    93797Physician services for remote monitoring of implantable ventricular assist device, review and interpretationMay be performed before or after holster replacement to review device data and confirm proper operation
    99213Office or other outpatient visit for the evaluation and management of an established patient, typically 15 minutesCommonly billed by VAD clinic providers to evaluate the patient and document medical necessity for holster replacement
    99070Supplies and materials (unlisted), provided by physician over and above usual office supplies, eachMay be used when billing for nonstandard accessory supplies associated with the replacement when payer allows
    A9270Non-covered item or service (used for supplies) — note: HCPCS Level II, not CPTOften used by suppliers to indicate miscellaneous DME supplies when a more specific code is not available; relates to accessory replacement documentation
    99080Special reports and documentation (e.g., to other agencies)Used when extensive documentation is provided to payers or durable medical equipment records are required during replacement

    Related Modifiers

    7 rows

    ModifierDescriptionWhen to Use
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
    82Modifier 82 is appended to a surgical CPT code to indicate that an attending physician acted as an assistant because a qualified resident surgeon was unavailable. In teaching hospitals it documents…- When to use: Append modifier 82 in teaching-hospital settings to indicate a physician served as an assistant surgeon because a qualified resident surgeon was unavailable (includes situations where…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    207L00000XAnesthesiology PhysicianAn anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an opera…
    364S00000XClinical Nurse SpecialistA registered nurse who, through a graduate degree program in nursing, or through a formal post-basic education program or continuing education courses…
    363L00000XNurse Practitioner(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision mak…
    101YP1600XPastoral CounselorBehavioral Health & Social Service Providers · Counselor
    213ES0000XSports Medicine PodiatristPodiatric Medicine & Surgery Service Providers · Podiatrist
    171R00000XInterpreterAn Interpreter is a person who translates oral communication between two or more people. This includes translating from one language to another or in…
    156FX1201XOptometric Assistant TechnicianAn optometric assistant assists optometrists by performing duties, including but not limited to, customer service, basic eye testing, and patient educ…
    2084E0001XEpilepsy PhysicianEpilepsy is a subspecialty of neurology focused on the diagnosis and treatment of patients with epilepsy, including new-onset, medically refractory ep…

    Related Payer Policy Updates

    Specialty: Infectious Disease1 / 3

    9 rows

    PolicyPayerEffective Date
    B-Hemolytic Streptococcus TestingOscar Health2026-10-01
    Human Immunodeficiency Virus (HIV) — Coverage Criteria for Testing and Resistance AssaysOscar Health2026-10-01
    Hepatitis Testing (A, B, C, D) Coverage CriteriaOscar Health2026-10-01
    Lyme Disease Testing Coverage CriteriaOscar Health2026-10-01
    Pathogen Panel TestingOscar Health2026-10-01
    Diagnostic Testing of Common Sexually Transmitted InfectionsOscar Health2026-10-01
    Testing for Vector-Borne InfectionsOscar Health2026-10-01
    Coronavirus Testing in the Outpatient SettingOscar Health2026-10-01
    Testing for Diagnosis of Active or Latent TuberculosisOscar Health2026-10-01

    Related Codes

    HCPCS-LEVEL-II-Q4139-INJECTABLE-AMNIOMATRIX-BIODMATRIX-1-CC

    HCPCS Q4139: Amniomatrix or Biodmatrix, Injectable, 1 cc

    HCPCS-LEVEL-II-Q4256-AREA-BASED-PROCEDURAL-ADD-ON-PER-SQ-CM

    HCPCS Q4256: MLG-complete Skin Graft Material, Per Sq Cm

    HCPCS-LEVEL-II-Q5132-ADALIMUMAB-AFZB-ABRILADA-10MG-INJECTION

    HCPCS Level II Q5132: Injection, adalimumab-afzb (Abrilada), 10 mg

    HCPCS-Q0035-CARDIOKYMOGRAPHY-CARDIAC-MOTION-RECORDING

    HCPCS Level II Q0035: Cardiokymography

    HCPCS-Q0081-INFUSION-THERAPY-NON-CHEMOTHERAPEUTIC-PER-VISIT

    HCPCS Level II Q0081: Infusion Therapy, Non‑Chemotherapeutic, Per Visit

    HCPCS-Q0083-CHEMOTHERAPY-NON-INFUSION-ADMINISTRATION

    HCPCS Q0083: Chemotherapy Administration, Non-Infusion Methods

    HCPCS-Q0084-CHEMOTHERAPY-INFUSION-ADMINISTRATION-PER-VISIT

    HCPCS Q0084: Chemotherapy Infusion Administration, Per Visit

    HCPCS-Q0085-CHEMOTHERAPY-INFUSION-PLUS-OTHER-TECHNIQUES-PER-VISIT

    HCPCS Q0085: Chemotherapy Infusion Plus Other Technique(s), Per Visit

    HCPCS-Q0091-PAP-SMEAR-SPECIMEN-COLLECTION-TRANSPORT

    HCPCS Q0091: Screening Papanicolaou Smear Collection and Transport

    HCPCS-Q0092-PORTABLE-XRAY-EQUIPMENT-SETUP

    HCPCS Q0092: Set-up Portable X-ray Equipment

    Showing 1–10 of 629

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    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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