Types of Cardiac Resynchronization Therapy(CRT-P / CRT-D) Coding
What is CRT?
Cardiac resynchronization therapy (CRT) is a newer generation of pacemakers and AICDs. Its distinguishing feature is an extra lead at the left ventricle, in addition to the leads at the right atrium and/or the right ventricle used with conventional pacemakers and AICDs.
CRT is also known as biventricular therapy because, with one lead at the right ventricle and another at the left ventricle, it coordinates the pumping action of the ventricles.
There are two types of cardiac resynchronization devices:
· CRT-pacemaker (CRT-P)
· CRT-defibrillator (CRT-D)
A cardiac resynchronization therapy pacing (CRT-P) system utilizes conventional pacing technology, but takes it one step further by adding a third lead, or electrode, to sense and pace the left ventricle.
The pacing device can then simultaneously stimulate both ventricles in synchrony with atrial activity. The synchronous contraction of both ventricles facilitates more adequate filling of the left ventricle and less backflow to the left atrium, resulting in more oxygenated blood being pumped to the body.
Cardiac resynchronization therapy has also been incorporated into automatic internal cardioverter-defibrillator devices (CRT-D), allowing for the simultaneous treatment of congestive heart failure with intraventricular conduction delays and the prevention of sudden cardiac death caused by life-threatening ventricular arrhythmias.
In physician’s operative notes, you may see CRT devices referred to as one of the following:
CRT-P
· Cardiac resynchronization therapy pacemaker
· Biventricular pacemaker
· Bi-V pacemaker
· Low power CRT
· Heart failure pacemaker
CRT-D
· Cardiac resynchronization therapy defibrillator
· Biventricular ICD
· Biventricular pacemaker with defibrillator
· Biventricular pacing with defibrillation
· High power CRT
· Heart failure pacemaker with defibrillator
· Heart failure pacemaker with ICD
