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    v1.0.28
    OpenPayerBilling CodesTemporary CodesHCPCS hcpcs-q0509-ventricular-assist-device-accessory-supply
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    HCPCS Q0509: Miscellaneous Accessory for Implanted Ventricular Assist Device

    HCPCS Level II code Q0509 describes a miscellaneous supply or accessory used with an implanted ventricular assist device when payment was not made under Medicare Part A; service type: durable medical equipment/supply accessory for implanted circulatory support devices; typical site of service: hospital inpatient or outpatient settings where ventricular assist devices are implanted or managed (e.g., surgical suite, cardiac ICU, or device clinic).

    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 advanced heart failure who has an implanted ventricular assist device (VAD) presents for outpatient device maintenance and replacement of a specialized, non‑routine accessory component not payable under Medicare Part A. Typical patients are adult or pediatric VAD recipients requiring replacement of supplies such as proprietary lead adapters, external controller accessories, or replacement dressing/connector kits that are billed separately from the device implantation. The clinical workflow begins with an interdisciplinary VAD clinic visit or device clinic review by a cardiothoracic surgeon, advanced heart failure cardiologist, or VAD coordinator. Device interrogation and inspection identify a malfunctioning or worn accessory. Orders are placed for the specific accessory; the supply is obtained by the hospital or home infusion/ durable medical equipment provider and is either exchanged during a clinic visit, home health visit, or during a readmission or outpatient procedure if needed. Billing uses HCPCS Level II code Q0509 to report the miscellaneous supply or accessory for use with any implanted ventricular assist device when the item is not paid under Medicare Part A. Typical sites of service include hospital outpatient departments, specialized VAD clinics, home health visits with durable medical equipment support, and ambulatory surgery centers when adjunct procedures are performed.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    93660Insertion or replacement of temporary transvenous pacing electrode with transvenous pacingPerformed when temporary pacing support is needed during VAD accessory manipulation or exchange
    33990Thoracotomy, surgical implantation of ventricular assist device, with cardiopulmonary bypass when performed; insertion of VAD (implant)Primary implantation procedure; subsequent accessory supplies like those billed with Q0509 support long‑term use
    33999Unlisted procedure, cardiac surgeryUsed for cardiac surgical procedures related to VAD system not otherwise classified; accessory work may accompany these cases
    36561Insertion of tunneled centrally inserted central venous catheter, with subcutaneous port or pumpMay be performed for infusion access in VAD patients requiring therapies during accessory replacement
    99070Supplies and materials (e.g., equipment, nonphysician services), provided by the physician over and above those usually included with the office visit or procedureOffice or clinic supply reporting when specific VAD supplies are provided in clinic alongside Q0509

    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…
    23Modifier -23 (Unusual Anesthesia) is used on anesthesia service CPT codes when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia…- Use modifier -23 only on anesthesia CPT codes (00100–01999) when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia because of…
    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…
    54Modifier ‑54 (“Surgical care only”) is appended to a CPT surgical procedure when the reporting surgeon performs the intraoperative (surgical) component but does not furnish the preoperative and/or…- Use modifier -54 when the reporting surgeon provided only the intraoperative (surgical) component of a procedure and preoperative and/or postoperative management has been or will be provided by…
    55Modifier –55 indicates the billing provider furnished only postoperative management for a procedure that has a global surgical period. According to AAPC, this modifier is appended to the same CPT…- Use modifier -55 when billing the same CPT surgical code that has a 10- or 90-day global period and you, as a provider other than the original surgeon, furnished ONLY postoperative management (no…
    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…

    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…
    207RG0300XGeriatric Medicine (Internal Medicine) PhysicianAn internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects o…
    163W00000XRegistered Nurse(1) A registered nurse is a person qualified by graduation from an accredited nursing school (depending upon schooling, a registered nurse may receive…
    282NW0100XWomen's HospitalHospitals · General Acute Care Hospital
    261QM0855XAdolescent and Children Mental Health Clinic/CenterAn entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disord…
    2083P0011XUndersea and Hyperbaric Medicine (Preventive Medicine) PhysicianA specialist who treats decompression illness and diving accident cases and uses hyperbaric oxygen therapy to treat such conditions as carbon monoxide…
    2080P0216XPediatric Rheumatology PhysicianA pediatrician who treats diseases of joints, muscle, bones and tendons. A pediatric rheumatologist diagnoses and treats arthritis, back pain, muscle …
    261QF0050XNon-Surgical Family Planning Clinic/CenterAn entity, facility, or distinct part of a facility, or mobile unit providing non-surgical, family planning/reproductive services including physical e…

    Related Payer Policy Updates

    Specialty: Infectious Disease1 / 3

    10 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 Diagnosis of Active or Latent TuberculosisOscar Health2026-10-01
    Testing for Vector-Borne InfectionsOscar Health2026-10-01
    Coronavirus Testing in the Outpatient SettingOscar Health2026-10-01
    Human Immunodeficiency Virus (HIV)blue cross blue shield - louisiana2026-09-15

    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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