Medical and surgical treatment options reviewed with patient (or caregiver) (Prkns)
CPT4 code
Name of the Procedure:
Medical and surgical treatment options reviewed with patient (Prkns)
Summary
This procedure involves a comprehensive discussion between the patient (or caregiver) and the healthcare provider to review both medical and surgical treatment options for Parkinson's disease (PD). The goal is to ensure the patient is well-informed about their choices and can make educated decisions regarding their care plan.
Purpose
The medical condition this addresses is Parkinson's disease, a progressive neurological disorder. The goal is to explore all potential treatments to manage symptoms and improve quality of life, including medications, surgical options like Deep Brain Stimulation (DBS), and lifestyle changes.
Indications
- Diagnose Parkinson’s disease or its progression
- Experience of motor symptoms such as tremors, stiffness, or slowness of movement
- Ineffectiveness or side effects of current medications
- Exploration of advanced treatment options
Preparation
- Patients may need to bring a list of current medications and medical history.
- Be ready to discuss symptom history and severity.
- Diagnostic tests or imaging results, such as MRI or CT scans, might be reviewed.
Procedure Description
- Initial consultation to assess the patient’s current condition and treatment history.
- Discussion of standard medical treatments, including different types of medication like Levodopa, Dopamine agonists, or MAO-B inhibitors.
- Exploration of surgical options, primarily Deep Brain Stimulation (DBS), including potential benefits and risks.
- Consideration of non-pharmacological treatments like physical therapy, occupational therapy, and lifestyle modifications.
- Questions and answers to address patient concerns and preferences.
Duration
The consultation typically lasts between 30 to 60 minutes.
Setting
This procedure is performed in a hospital outpatient clinic, neurologist's office, or specialized movement disorder center.
Personnel
- Neurologist specializing in movement disorders
- Neurosurgeon (for surgical options discussions)
- Nurse or physician assistant
- Physical and occupational therapists (if applicable)
Risks and Complications
- Side effects of medications, such as nausea and dizziness
- Surgical risks, like infection, bleeding, or anesthesia-related issues
- Potential for non-responsiveness to treatment or varied effectiveness
Benefits
- Improved symptom management
- Informed decision-making regarding treatment plans
- Potential for enhanced quality of life and daily functioning
- Understanding all available treatment options
Recovery
- For medication adjustments, follow-up appointments for monitoring and dose tweaking may be required.
- For surgical options like DBS, recovery involves post-operative care, initial programming of the device, and regular follow-up visits.
Alternatives
- Continuing current medication regimen with potential dose adjustments
- Non-invasive therapies such as physical or speech therapy
- Complementary therapies like acupuncture or herbal treatments
- Each alternative comes with its own set of benefits and drawbacks that will be compared during the consultation.
Patient Experience
- The discussion can be overwhelming; it's advisable to take notes.
- Emotional support from caregivers or family members may be beneficial.
- Post-discussion, patients might need time to consider their options before making a decision.