The AASM worked with the American College of Cardiology (ACC) and the Heart Rhythm Society (HRS) to convert 12 phrenic nerve stimulation (PNS) Category III codes to Category I codes. The AMA Current Procedural Terminology (CPT) Editorial Panel accepted the addition of codes 3X008-3X015 to report insertion, removal, revision, repositioning, and replacement of phrenic nerve stimulation system and/or its component as well as addition of codes 9X045-9X048 to report phrenic nerve stimulation system programming during its September 2022 meeting.
The eight medical/surgical codes and four programming codes for PNS were accepted by the CPT Panel and referred to the AMA/Specialty Society Relative Value Scale Update Committee (RUC) for valuation at its January 2023 meeting. The ACC, HRS and AASM surveyed their respective members with both targeted and random surveys. The AASM surveyed members on the programming codes only (9X045-9X048), while the ACC and HRS surveyed their members on all 12 of the codes. One of the PNS codes met the minimum number of survey responses needed for valuation by the RUC (n=30). However, the RUC was able to draft values to present to the Centers for Medicare & Medicaid Services (CMS) for consideration based on the 25th percentile of responses and crosswalks to other existing codes.
CMS will publish the final work RVUs for each code in the physician fee schedule final rule for 2024. AASM health policy staff will share the final values once published by CMS.
Learn more from the AASM about sleep medicine coding and reimbursement. For more information on the PNS code family, please submit your inquiries to coding@aasm.org.
| Code | Decriptor |
|---|---|
| 3X008 | Insertion of phrenic nerve stimulator system (pulse generator and stimulating lead[s]) including vessel catheterization, all imaging guidance, and pulse generator initial analysis with diagnostic mode activation when performed. (Do not report 3X008 in conjunction with 9X045, 9X046, 9X047, 9X048) |
| 3X009 | Insertion of phrenic nerve stimulator transvenous sensing lead (List separately in addition to code for primary procedure) (Use 3X009 in conjunction with 3X008, 3X014) (For insertion of a phrenic nerve sensing lead other than at initial insertion of the phrenic nerve stimulator system, use 33999) |
| 3X010 | Removal of phrenic nerve stimulator including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; system, including pulse generator and lead(s) |
| 3X011 | Removal of phrenic nerve stimulator including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; transvenous stimulation or sensing lead(s) only. (Use 3×011 once for removal of one or more lead[s]) |
| 3X012 | Removal of phrenic nerve stimulator including vessel catheterization, all imaging guidance, and interrogation and programming, when performed, pulse generator only. (Do not report 3X010, 3X011, 3X012 in conjunction with 3X008, 3X009, 3X013, 3X014, 3X015) |
| 3X013 | Repositioning of phrenic nerve stimulator transvenous lead(s) (Report 3X013 only once per patient per day) (Do not report 3X013 in conjunction with 3X008, 3X009) |
| 3X014 | Removal and replacement of phrenic nerve stimulator including vessel catheterization, all imaging guidance, and interrogation and programming when performed, pulse generator. (Do not report 3X014 in conjunction with 3X008, 3X010) |
| 3X015 | Removal and replacement of phrenic nerve stimulator including vessel catheterization, all imaging guidance, and interrogation and programming when performed, transvenous stimulation or sensing lead. (Do not report 3X015 in conjunction with 3X009, 3X011, 3X013) |
| 9X045 | Therapy activation of implanted phrenic nerve stimulator system including all interrogation and programming (Do not report 9X045 in conjunction with 3X008, 3X009, 3X010, 3X011, 3X012, 3X013, 9X046, 9X047, 9X048) |
| 9X046 | Interrogation and programming (minimum one parameter) of implanted phrenic nerve stimulator system (Do not report 9X046 in conjunction with 9X045, 9X047, 9X048) (For interrogation without programming, use 9X048) |
| 9X047 | Interrogation and programming of implanted phrenic nerve stimulator system during a polysomnography (Do not report 9X047 in conjunction with 3X008, 9X045, 9X046, 9X048) (For polysomnography, see 95808, 95810, 95811, 95782, 95783) |
| 9X048 | Interrogation, without programming of implanted phrenic nerve stimulator system (Do not report 9X048 in conjunction with 3X008, 9X045, 9X046, 9X047) |
