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Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent delivery and management, per session
CPT4 code
Name of the Procedure
Therapeutic Repetitive Transcranial Magnetic Stimulation (TMS) Treatment; subsequent delivery and management, per session
Summary
Therapeutic repetitive transcranial magnetic stimulation (TMS) is a non-invasive treatment that involves using magnetic fields to stimulate nerve cells in the brain. It's typically performed on an outpatient basis and does not require anesthesia.
Purpose
Therapeutic TMS is primarily used to treat major depressive disorder (MDD) that hasn't responded to traditional treatments such as medication and psychotherapy. The goal is to reduce symptoms of depression and improve the patient's quality of life.
Indications
- Major depressive disorder (MDD) that is resistant to other treatments
- Other conditions sometimes considered include anxiety disorders, PTSD, and certain forms of chronic pain
Preparation
- No special preparation like fasting is typically required
- Patients should inform their doctor of any medications they are taking
- Baseline assessments of mental health will likely be performed
Procedure Description
- The patient sits in a reclining chair.
- A magnetic coil is placed against the patient's head, usually near the forehead.
- Magnetic pulses are delivered through the coil to stimulate nerve cells in the brain.
- The healthcare provider will monitor the patient throughout the session.
Tools, Equipment, or Technology Used
- TMS device with magnetic coil
Anesthesia or Sedation
- None required; the procedure is non-painful and minimally discomforting
Duration
Each session typically lasts about 30 to 60 minutes.
Setting
- Outpatient clinic or specialized treatment center
Personnel
- Trained technicians or healthcare providers
- Supervising psychiatrist or neurologist
Risks and Complications
Common Risks
- Mild headache or scalp discomfort ##### Rare Risks
- Seizures (very rare)
- Temporary hearing problems if proper ear protection isn’t used
Benefits
- Reduction in symptoms of depression
- Improved mood and quality of life
- Benefits may be seen after a few weeks of regular sessions
Recovery
- No significant downtime required
- Patients can usually return to their normal activities immediately following the session
- Follow-up sessions typically occur multiple times per week over several weeks
Alternatives
- Pharmacotherapy (medication)
- Psychotherapy (counseling or talk therapy)
- Electroconvulsive therapy (ECT)
- Each alternative has its own risks and benefits that should be discussed with a healthcare provider
Patient Experience
- Patients might feel a tapping sensation on the head or hear a clicking sound during the procedure
- Mild discomfort or headache post-session is possible but usually temporary
- Pain management strategies, like over-the-counter pain relievers, can be used if needed