90868 Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent delivery and management, per session

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

1. The patient sits in a reclining chair.
2. A magnetic coil is placed against the patient's head, usually near the forehead.
3. Magnetic pulses are delivered through the coil to stimulate nerve cells in the brain.
4. 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