93287 Peri-procedural device evaluation (in person) and programming of device system parameters before or after a surgery, procedure, or test with analysis, review and report by a physician or other qualified health care professional; single, dual, or multiple

Name of the Procedure:

Peri-procedural Device Evaluation and Programming

Summary:

Peri-procedural device evaluation and programming involve assessing and adjusting the settings of a medical device just before or after a surgery, procedure, or diagnostic test. This ensures that the device functions correctly and optimally supports the patient's health needs.

Purpose:

This procedure addresses the need to verify the proper functioning of implanted or external medical devices, such as pacemakers or infusion pumps, around the time of surgery or other medical interventions. The goal is to maintain or restore optimal device performance and thus improve patient outcomes.

Indications:

• Presence of an implanted medical device requiring adjustment before or after a procedure.
• Symptoms suggesting device malfunction or suboptimal performance.
• Scheduled surgeries or diagnostic tests that necessitate verification and setting adjustments of the device.
• Specific medical conditions managed by programmable devices, such as heart arrhythmias or chronic pain.

Preparation:

• Patients may need to provide information about their device, such as a device identification card.
• Fasting or medication adjustments might be required based on the type of device and the nature of the surgery or procedure.
• Pre-procedure diagnostic tests, such as blood tests or imaging, might be performed.

Procedure Description:

1. Initial Evaluation: The healthcare provider will assess the device through physical examination and checking device records.
2. Device Interrogation: Using specialized equipment, the device will be interrogated to gather data on its current function and settings.
3. Adjustment: Based on the collected data, the device settings may be reprogrammed to better suit the patient's needs or the upcoming procedure.
4. Verification: The revised settings are checked to ensure the device operates within safe and optimal parameters.
5. Documentation: A detailed report of the analysis, review, and changes made is compiled.

Tools used may include a programmer device, interrogator, and computer systems for data analysis. Anesthesia or sedation is generally not required.

Duration:

The procedure typically takes 30 minutes to 1 hour, depending on the complexity of the device and the adjustments needed.

Setting:

This procedure is usually performed in hospitals, outpatient clinics, or specialized medical centers.

Personnel:

Involves physicians or other qualified healthcare professionals trained in device management, such as cardiologists, electrophysiologists, or specialized nurses.

Risks and Complications:

• Minor discomfort during the device interrogation.
• Rare risks include infection at the implant site if device reprogramming requires access to a surgically implanted unit.
• Device malfunction if programming is incorrect (rare and usually quickly resolved).

Benefits:

• Ensures the device functions correctly before, during, and after a medical procedure.
• Prevents complications related to device malfunction.
• Improves outcomes of the primary surgery/procedure by optimizing device performance.

Recovery:

• Minimal to no recovery time required.
• Patients can usually resume normal activities immediately after.
• Follow-up appointments may be scheduled for further evaluation or adjustments.

Alternatives:

• Manual management of symptoms without device adjustment, though typically less optimal.
• Different therapeutic strategies, depending on the underlying condition, like medication changes or alternative interventions.

Patient Experience:

Patients might feel minor discomfort during device interrogation. Adjustments are typically non-invasive and not painful. Post-procedure, patients usually feel no different but benefit from improved device operation. Pain management and comfort measures are generally unnecessary beyond normal clinical care.