0466T Insertion of chest wall respiratory sensor electrode or electrode array, including connection to pulse generator (List separately in addition to code for primary procedure)

Name of the Procedure:

Insertion of Chest Wall Respiratory Sensor Electrode or Electrode Array, including Connection to Pulse Generator

Summary

This procedure involves placing a respiratory sensor electrode or a series of electrodes on the chest wall to monitor respiratory patterns. These electrodes are connected to a pulse generator, which helps manage respiratory functions. It is often an additional procedure performed alongside a primary surgical intervention.

Purpose

This procedure addresses respiratory issues such as sleep apnea or chronic obstructive pulmonary disease (COPD). The goal is to improve breathing patterns, monitor respiratory functions continuously, and provide data that can be used for better management of respiratory disorders.

Indications

• Severe sleep apnea
• Chronic obstructive pulmonary disease (COPD)
• Respiratory failure that requires close monitoring
• Patients with pacemakers needing additional respiratory monitoring

Preparation

• Fasting for at least 8 hours before the procedure if sedation is to be used
• Discontinuation of specific medications as recommended by the healthcare provider
• Pre-procedure diagnostic tests such as chest X-rays or pulmonary function tests

Procedure Description

1. The patient is positioned comfortably, usually lying on their back.
2. An IV line is placed for administration of medication.
3. Local anesthesia or light sedation is administered.
4. The chest wall is cleaned and sterilized.
5. A small incision is made to insert the electrode(s) onto the chest wall.
6. The electrode array is connected to a pulse generator.
7. The incision site is closed with sutures.
8. The connection and functionality of the electrodes with the pulse generator are tested to ensure they are working correctly.

Duration

The procedure typically takes about 1 to 2 hours.

Setting

The procedure is performed in a hospital’s surgical unit or an outpatient surgical center.

Personnel

• Cardiothoracic surgeon or specialized surgeon
• Anesthesiologist or nurse anesthetist
• Surgical nurse
• Respiratory therapist (if needed)

Risks and Complications

• Infection at the incision site
• Bleeding or hematoma formation
• Displacement or malfunction of the electrode array
• Unintended reactions to anesthesia
• Nerve damage

Benefits

• Improved monitoring and management of respiratory disorders
• Enhanced quality of life due to better respiratory function
• Data from the sensor can inform treatment adjustments

Recovery

• Stay in the recovery area for monitoring right after the procedure
• Pain management with prescribed medications
• Keep the incision site clean and dry
• Avoid strenuous activities for a few weeks
• Follow-up appointments to check electrode placement and function

Alternatives

• Continuous Positive Airway Pressure (CPAP) therapy for sleep apnea
• Non-invasive respiratory monitoring devices
• Oxygen therapy for COPD and other respiratory conditions
• Pros of alternatives: Non-invasive, minimal recovery time
• Cons of alternatives: May not provide the same level of monitoring and control

Patient Experience

• During the procedure: Some discomfort, but generally painless due to local anesthesia or light sedation
• After the procedure: Mild soreness at the incision site, activity restrictions, and slight discomfort that should subside within a few days
• Pain management with prescribed medications and proper after-care instructions will ensure comfort. Follow-up visits will address any concerns and adjust treatment plans as needed.

By providing continuous monitoring and potentially therapeutic interventions, this procedure can significantly impact the patient's overall respiratory health and quality of life.