# Ventricular assist device(Impella) coding



## LThompson0721

Can anyone assist with the appropriate circumstances to bill for CPT 33975(insert Ventricular assist device extracorporeal, single ventricle)(for example,Impella), and CPT 33977(removal of Ventricular assist device).
These are normally used for ventricular assist while a patient is awaiting a heart transplant.
They are very high value codes--Is it advisable to use them for ventricular assist insert and removal, during a difficult coronary intervention but with modifier 52 for reduced services since the device does not remain in the patient?  Thanks--


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## deeva456

the code for implanting the Impella device is 92970. There isnt a code for the removal. 

Dolores, CPC-CCC


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## bkiesecker

actually there is no code for a percutaneous impella devise implant or removal 

there are many source that recommend using a unlisted code (33999) to code for the implant of the devise and then the removal 

but you need to check with the devise rep and your local carrier


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## cweavercpc

*Impella*

We currently use Impella for the same reason and use the 33999 cpt code.  We have Cahaba GBA as our medicare carrier.  These claims first request medical records and then sometimes we have to appeal.  We send a letter of appeal with a crosswalk to cpt 33975 for a comparable RVU and also send all of the referenced info recieved from the rep explaining the device and the letter form FDA and such. So far most of these have paid and the one that didn't denied for not med nec in which we will send to Q2 appeals. 

Oh and we usually take the device out at the end of the procedure so we only bill the 33999 code once.  In some cases where it is left in a few days we will bill for the removal and again use the 33999.

Hope this helps!


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