RetiredLocal Coverage ArticleBilling and Coding
A54910
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Contractor Information
Article Information
General Information
Article ID
A54910
Article Title
Billing and Coding: Ventricular Assist Device (VAD) Supply or Accessory
Article Type
Billing and Coding
Original Effective Date
10/01/2015
Revision Effective Date
11/21/2019
Revision Ending Date
04/06/2023
Retirement Date
04/06/2023
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Article Guidance
Article Text Refer to CMS Change Request 7888 for complete instructions regarding HCPCS codes for replacement accessories and supplies for external ventricular assist devices or any ventricular assist device (VAD) for which payment was not made under Medicare Part A. This Article is effective for all services billed on or after 09/14/2015, regardless of date of service. Novitas Solutions is receiving claims for various prepackaged supplies or accessories used for an implanted ventricular assist device (VAD). The supplies have been reported using Healthcare Common Procedure Codes (HCPCS) (e.g. Q0508, Q0509). The prepackaged supplies typically contain various items including but not limited to gloves, gauze, tape, anchoring device, bouffant cap, local antiseptic (betadine/dyna dex/chloraprep), and facemask. When billing for a miscellaneous supply or accessory for use with a VAD, (Q0508 or Q0509), Medicare expects the following documentation to be made available: The documentation must be made available to Medicare upon request, and should be included at the time of the claim submission.
Coding Information
CPT/HCPCS Codes
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Group 1
(2 Codes)
Group 1 Paragraph N/A
| Code | Description |
|---|---|
| Q0508 | Mis sup/acc imp vad |
| Q0509 | Mis sup/ac imp vad nopay med |
CPT/HCPCS Modifiers
N/A
ICD-10-CM Codes that Support Medical Necessity
N/A
ICD-10-CM Codes that DO NOT Support Medical Necessity
N/A
ICD-10-PCS Codes
N/A
Additional ICD-10 Information
N/A
Bill Type Codes
Contractors may specify Bill Types to help providers identify those Bill Types typicallyused to report this service. Absence of a Bill Type does not guarantee that thearticle does not apply to that Bill Type. Complete absence of all Bill Types indicatesthat coverage is not influenced by Bill Type and the article should be assumed toapply equally to all claims.
| Code | Description |
|---|---|
| 999x | Not Applicable |
Revenue Codes
Contractors may specify Revenue Codes to help providers identify those Revenue Codes typically used to report this service.In most instances Revenue Codes are purely advisory. Unless specified in the article, services reported under otherRevenue Codes are equally subject to this coverage determination. Complete absence of all Revenue Codes indicatesthat coverage is not influenced by Revenue Code and the article should be assumed to apply equally to all Revenue Codes.
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Other Coding Information
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Revision History Information
| Revision History Date | Revision History Number | Revision History Explanation |
|---|---|---|
| 04/21/2023 | R3 | This article is being retired because it is no longer being used for education. |
| 11/21/2019 | R2 |
|
| 08/03/2017 | R1 | Article revised to remove the language specific to the number of kits reported within a specified timeframe. The Article continues to be effective for any claims submitted regardless of date of service. |
Associated Documents
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Statutory Requirements URLs
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CMS Manual Explanations URLs
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Public Versions
| Updated On | Effective Dates | Status | |
|---|---|---|---|
| 04/21/2023 | 11/21/2019 - 04/06/2023 | Retired | You are here |
| 11/15/2019 | 11/21/2019 - N/A | Superseded | View |
| Some older versions have been archived. Please visit theMCD Archive Site to retrieve them. | |||
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Submit Feedback/Ask a Question
FAQs
What is the CPT code for ventricular assist device? ›
| Code | Description |
|---|---|
| 33990 | INSERTION OF VENTRICULAR ASSIST DEVICE, PERCUTANEOUS, INCLUDING RADIOLOGICAL SUPERVISION AND INTERPRETATION; LEFT HEART, ARTERIAL ACCESS ONLY |
Article - Billing and Coding: Ventricular Assist Device (VAD) Supply or Accessory (A54910)
What is the CPT code for Impella ventricular assist device? ›CPT code 33992 (removal) and CPT code 33993 (repositioning) may be billed and paid for in addition to CPT code 33990 (insertion) if performed during a separate session. Medicare's definition of a separate session is that the services be performed during a different patient encounter.
What is the difference between Level 1 and Level 2 HCPCS codes? ›Note: Level I of HCPCS (CPT-4 codes) does not include codes for medical items/services that are regularly billed by suppliers other than physicians. Level II of the HCPCS is used primarily to identify products, supplies and services that are not identified by CPT-4codes.
What is the ICD-10 code for ventricular assist device? ›ICD-10 code Z95. 811 for Presence of heart assist device is a medical classification as listed by WHO under the range - Factors influencing health status and contact with health services .
What is the ICD 10 PCS code for ventricular assist device? ›Part A Providers: ICD-10-PCS codes: 5A02116 - Assistance with Cardiac Output using Other Pump, Intermittent.
What is the ICD-10 code for VAD placement? ›Z95. 811 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.
What is the CPT code for VAD replacement? ›CPT® Code 33982 in section: Replacement of ventricular assist device pump(s)
What is the ICD-10 code for management of VAD? ›Z45. 2 Encounter for adjustment and management of VAD - ICD-10-CM Diagnosis Codes.
What is the billing code for Impella? ›Any repositioning of the Impella® device that occurs in the ICU (with documentation of imaging guidance) can also be coded and billed using CPT 33993.
Is LVAD and Impella the same? ›
What is Impella? Impella Ventricular Support System is a small Left Ventricular Assist Device (LVAD). It is designed to help pump blood in patients who require short term support.
Is Impella a ventricular assist device? ›The Impella device is a catheter-based miniaturized ventricular assist device that pumps blood from left ventricle (LV) into ascending aorta and responsible for systemic circulation at an upper rate between 2.5 and 5.0 L/min.
Is there a difference between a billable and a payable HCPCS Level II DME code? ›A billable HCPCS code is one that can be submitted on a claim to the DME MAC. A payable HCPCS code is one that will be considered for payment by the DME MACs only if the item meets the definition of DME, falls under a benefit category, and is covered under other general DME guidelines.
How can you tell the difference between a CPT code and a HCPCS code? ›HCPCS codes are for basic healthcare services like medical devices, medical supplies, etc. These codes provide a standardized description of the services. CPT codes are for services like surgeries, diagnostic tests, evaluation and management services (E&M), etc.
Why do we need HCPCS Level 2 codes? ›Level II of the HCPCS is a standardized coding system that is used primarily to identify products, supplies, and services not included in the CPT-4 codes, such as ambulance services and durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) when used outside a physician's office.
What is the ICD 9 code for left ventricular assist device? ›We defined LVAD implantations as hospital discharges that included the ICD-9-CM procedure code for LVAD implantation (37.66).
What is the ICD-10 for cardiac device status? ›Presence of automatic (implantable) cardiac defibrillator
Z95. 810 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2023 edition of ICD-10-CM Z95.
Left ventricular assist device (LVAD) is the most common. It helps the left side of your heart pump oxygen-rich blood from the heart out to your body. Right ventricular assist device (RVAD) pumps oxygen-poor blood from the right side of your heart to your lungs.
What is the ICD-10-PCS code for AVR? ›Repair Aortic Valve created from Truncal Valve, Open Approach. ICD-10-PCS 02QF0ZJ is a specific/billable code that can be used to indicate a procedure.
What is the ICD-10 for ventricular screening? ›ICD-10 code: Z13. 6 Special screening examination for cardiovascular disorders.
What is Z95 4 ICD-10? ›
ICD-10 code: Z95. 4 Presence of other heart-valve replacement.
Can you have both ICD and LVAD? ›ICD therapy has become the treatment of choice for prevention of sudden cardiac death due to ventricular tachyarrhythmias in heart failure patients [4]. Many patients receiving an LVAD already have an ICD implanted or receive ICD implantation following LVAD implantation.
What is the placement of VAD? ›A VAD is most frequently placed in the left lower heart chamber, called the left ventricle. When placed in the left ventricle, it's called a left ventricular assist device (LVAD). This article focuses on LVADs . Current LVADs provide a constant flow of blood from the heart to the body.
What is the CPT code for VAD interrogation? ›Per CPT description - the below listed parameters/device functions must be documented in the LVAD Interrogation report. 93750 reports a diagnostic procedure that is performed in person and includes a face-to-face assessment of all device functions.
Is a VAD the same as a pacemaker? ›The function of a VAD differs from that of an artificial cardiac pacemaker in that a VAD pumps blood, whereas a pacemaker delivers electrical impulses to the heart muscle.
What is the cost of ventricular assist device VAD? ›The Left Ventricular Assist Device (LVAD) surgery cost in Hyderabad differs based on various factors. However, an LVAD can cost anywhere around Rs. 25 Lakhs in India.
What is the CPT code for implanted vascular access device placement? ›CPT® Code 36561 - Insertion of Central Venous Access Device - Codify by AAPC.
What is the ICD-10 code for mechanical complication of VAD? ›2023 ICD-10-CM Diagnosis Code T82. 5: Mechanical complication of other cardiac and vascular devices and implants.
What is the ICD-10 code for complication of heart assist device? ›ICD-10 code T82. 1 for Mechanical complication of cardiac electronic device is a medical classification as listed by WHO under the range - Injury, poisoning and certain other consequences of external causes .
What is the ICD-10 procedure code for aortic valve replacement? ›2023 ICD-10-PCS Procedure Code 02RF38N: Replacement of Aortic Valve with Zooplastic Tissue, using Rapid Deployment Technique, Percutaneous Approach.
What are the billing codes for endovascular? ›
Endovascular repair in the aortic or iliac arteries for acute rupture is reported using CPT codes 34702, 34704, 34706, or 34708.
What is medical billing code 93224? ›CPT codes for Holter monitoring services (CPT codes 93224-93227) are intended for up to 48 hours of continuous recording. The documentation in the progress notes must reflect medical necessity for the service. These services may be reported globally with CPT codes 93224.
What is billing code H0032? ›A: H0032 is intended to be used when a separate encounter is required for coordinating/discussing/completing a treatment plan with your client.
What are the two types of VAD devices? ›The two basic types of VADs are a left ventricular assist device (LVAD) and a right ventricular assist device (RVAD). If both types are used at the same time, they may be called a biventricular assist device (BIVAD).
Is Impella considered a VAD? ›Another type of paracorporeal VAD, called the Impella 2.5 Cardiac Assist Device, has a very small pump located on the tip of a catheter.
Is it left ventricular assist device or LVAD? ›What Is a LVAD? A left ventricular assist device (LVAD) is a pump that we use for patients who have reached end-stage heart failure. We surgically implant the LVAD, a battery-operated, mechanical pump, which then helps the left ventricle (main pumping chamber of the heart) pump blood to the rest of the body.
What is an example of a ventricular assist device? ›Abbott HeartMate 3® Left Ventricular Assist Device
The HeartMate 3™ assists your heart in pumping blood throughout your body and increasing the supply of oxygen to your organs. Designed with Full MagLev™ flow technology, the HeartMate 3 LVAD helps protect the blood as it flows through the pump.
Compared with a pacemaker
An LVAD and a pacemaker serve different purposes. While an LVAD helps the heart pump blood effectively, a pacemaker helps correct an irregular or slow heartbeat. It does not help with pumping — instead, a pacemaker generates electrical stimulation that regulates the heartbeat.
CPT® 37252, Under Intravascular Ultrasound Procedures on Arteries and Veins. The Current Procedural Terminology (CPT®) code 37252 as maintained by American Medical Association, is a medical procedural code under the range - Intravascular Ultrasound Procedures on Arteries and Veins.
What is CPT code 33990? ›The Current Procedural Terminology (CPT®) code 33990 as maintained by American Medical Association, is a medical procedural code under the range - Cardiac Assist Procedures.
What is CPT code 93750? ›
93750 reports a diagnostic procedure that is performed in person and includes a face-to-face assessment of all device functions. Components that must be evaluated include device parameters (alarms, drivelines, and power surges) and a review of the device function (flow/volume status, septum status, and recovery).
What is CPT code 33970? ›CPT® Code 33970 - Cardiac Assist Procedures - Codify by AAPC.
What is CPT code 37252 and 37253? ›Intravascular Ultrasound Procedures on Arteries and Veins CPT® Code range 37252- 37253. The Current Procedural Terminology (CPT) code range for Surgical Procedures on Arteries and Veins 37252-37253 is a medical code set maintained by the American Medical Association.
What CPT code is 37224? ›37224 Revascularization, endovascular, open or percutaneous, femoral, popliteal artery(s), unilateral; with transluminal angioplasty Work 8.75 Total 12.94 $452 $3,459 37225 Revascularization, endovascular, open or percutaneous, femoral, popliteal artery(s), unilateral; with atherectomy, includes angioplasty within the ...
Can 52005 and 50590 be billed together? ›Indicator 1 – CPT 50590 & 52005 have an edit; CPT 50590 is a Column 1 and CPT 52005 is a Column 2 so when medically appropriate and documented correctly, these two codes can be billed together with a modifier.
What is CPT code 33991? ›CPT® 33991 in section: Insertion of ventricular assist device, percutaneous, including radiological supervision and interpretation.
What is CPT code 49590? ›Significant coding changes take effect in 2023 for reporting anterior abdominal hernia repair, including: Deletion of codes 49560–49590, which describe open repair of anterior abdominal hernias.
What is the billing code 93793? ›93793 Is payment for managing patients taking warfarin. It includes the review and interpretation of a new lab test done in the home, office or lab.
Can 99214 and 93793 be billed together? ›The CPT guidelines for code 93793 state: “Do not report 93793 on the same date of service as an E/M service." However, they also have the following parenthetical note: "(Do not report 93793 in conjunction with 99201,99202, 99203, 99204, 99205, 99211, 99212, 99213, 99214, 99215, 99241, 99242, 99243, 99244, 99245)." We ...
What is 93784 billing guidelines? ›CPT Coding:
93784. Ambulatory blood pressure monitoring, utilizing report-generating software, automated, worn continuously for 24 hours or longer; including recording, scanning. analysis, interpretation and report. 93786.
What is medical CPT code 87426? ›
What is CPT Code 87426 Antigen Testing Code? Furthermore, the code, 87426, represents antigen tests using an immunofluorescent or immunochromatographic technique for the detection of biomolecules produced by the SAR-CoV-2 virus (COVID-19).
What is billing CPT code 36247? ›CPT® 36247, Under Intra-Arterial (Catheter and Infusion Pump) Procedures. The Current Procedural Terminology (CPT®) code 36247 as maintained by American Medical Association, is a medical procedural code under the range - Intra-Arterial (Catheter and Infusion Pump) Procedures.
What is CPT 62270 and 96450? ›The appropriate code is 96450 - intrathecal chemotherapy injection - and it includes the spinal puncture. If the oncologist bills 96450 and the radiologist bills 62270 or 62272, then the patient is being double billed for the spinal puncture.