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Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care

CPT4 code

Name of the Procedure:

Programming Device Evaluation (In Person)

Summary

A programming device evaluation is a process where a healthcare provider tests and adjusts an implanted medical device to ensure it functions correctly. The adjustments are made to find the most effective settings for the individual patient. It includes analysis, review, and a report by a qualified healthcare professional.

Purpose

The goal of this procedure is to ensure the implantable device, such as a pacemaker or neurostimulator, operates at optimal settings. The expected outcome is improved device performance, which can enhance the patient's health and quality of life.

Indications

  • Irregular heartbeats (arrhythmias)
  • Chronic pain management
  • Conditions requiring neurostimulation
  • Any circumstances where an implantable device is not performing as expected
  • Routine follow-ups to check device functionality

Preparation

  • No special fasting required
  • Patients may be asked to list all medications they are taking
  • Routine diagnostic tests like ECG or device-specific diagnostics may be performed beforehand

Procedure Description

  1. The patient arrives at the clinic or hospital.
  2. The physician or qualified healthcare professional accesses the implanted device using a specialized external programmer.
  3. Initial diagnostic tests on the device are conducted to evaluate its current settings and performance.
  4. Iterative adjustments are made to the device's settings, testing the function after each change.
  5. The optimal permanent programmed values are determined and set.
  6. Final tests are conducted to ensure the device operates correctly.
  7. A thorough analysis, review, and report are completed by the healthcare provider.

Tools and Equipment: External programmer specific to the device, diagnostic equipment

Anesthesia/Sedation: Not typically required

Duration

30 to 60 minutes

Setting

  • Hospital
  • Outpatient clinic
  • Surgical center

Personnel

  • Physician or cardiologist (for cardiac devices)
  • Nurse or medical technician
  • Possibly a biomedical engineer for technical support

Risks and Complications

  • Minor discomfort during adjustments
  • Potential for device malfunction if not properly adjusted
  • Rare risk of infection at the site of device interaction

Benefits

  • Ensures the device operates at its optimal settings
  • Can significantly improve symptoms related to the medical condition
  • Enhances the overall quality of life for the patient

Recovery

  • Immediate post-procedure monitoring
  • Patients can typically resume normal activities immediately
  • Follow-up appointments may be scheduled to reassess device performance

Alternatives

  • Medication adjustments for managing symptoms
  • Other non-invasive treatments relevant to the specific medical condition
  • In some cases, surgical revision or replacement of the implanted device

Pros and Cons of Alternatives:

  • Medications may not be as effective and can have side effects
  • Non-invasive treatments vary in effectiveness
  • Surgical options carry more significant risks and longer recovery times

Patient Experience

During the procedure, patients might feel mild sensations or very minor discomfort. No significant pain is involved, and the healthcare provider takes measures to ensure comfort. After the procedure, most patients feel fine and can go about their usual activities.

Pain management is generally not needed for this procedure, but any discomfort experienced can be discussed and addressed promptly by the healthcare provider.

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