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Electroencephalogram with video (VEEG), review of data, technical description by EEG technologist, each increment of 12-26 hours; with continuous, real-time monitoring and maintenance

CPT4 code

Name of the Procedure:

Electroencephalogram with Video (VEEG), with Continuous, Real-Time Monitoring and Maintenance for 12-26 Hours

Summary

An Electroencephalogram with Video (VEEG) is a diagnostic test that records electrical activity in the brain while simultaneously capturing video footage of the patient over an extended period. This helps correlate brain activity with physical behavior and symptoms.

Purpose

The VEEG is used to diagnose and monitor various neurological conditions, such as epilepsy, sleep disorders, and other brain dysfunctions. The goal is to capture real-time data to provide a comprehensive analysis of brain activity related to behavioral patterns.

Indications

  • Unexplained seizures or epilepsy
  • Sleep disorders
  • Suspected neurological events
  • Diagnosis and differentiation of various types of seizures
  • Monitoring treatment effectiveness

Preparation

  • Patients may be asked to reduce sleep the night before the test.
  • Avoid caffeine for 8-12 hours prior to the procedure.
  • Wash hair and scalp thoroughly but avoid using conditioner or styling products.
  • Continue taking prescribed medications unless instructed otherwise.

Procedure Description

  1. Preparation: Electrodes are attached to the patient's scalp using a special adhesive or conductive paste.
  2. Video Setup: The patient is positioned in front of a camera for continuous video recording.
  3. Monitoring: EEG technologist monitors and records brain activity and patient behavior for a period ranging from 12 to 26 hours.
  4. Data Review: Real-time monitoring allows for immediate recognition of abnormal activity, ensuring the integrity of the data.
  5. Maintenance: Ongoing adjustments to the electrodes or recording equipment may be done to maintain quality data collection.

Duration

The procedure usually takes between 12 to 26 hours.

Setting

The procedure is typically performed in a hospital setting, specifically in a monitored VEEG lab or room.

Personnel

  • EEG Technologists
  • Neurologists and/or Epileptologists
  • Nursing staff

Risks and Complications

  • Skin irritation or infection at electrode sites
  • Possible discomfort due to prolonged periods of video monitoring
  • Rare: accidental falls or injuries during seizures while being monitored

Benefits

  • Accurate diagnosis of neurological conditions
  • Real-time data helps tailor specific treatment plans
  • Correlation of physical behavior with electrical brain activity
  • Immediate intervention if abnormal activity is detected

Recovery

  • Patients can typically return to normal activities shortly after the procedure.
  • Instructions may include washing hair to remove adhesive residue.
  • Follow-up appointments to discuss results and possible next steps.

Alternatives

  • Standard EEG without video
  • Ambulatory EEG (portable, shorter duration)
  • Neuroimaging techniques (MRI, CT scans)

Pros and cons of alternatives:

  • Standard EEG is shorter and simpler but may not capture every event.
  • Ambulatory EEG offers more flexibility but lacks continuous real-time monitoring.
  • Neuroimaging provides structural but not functional data.

Patient Experience

Patients lie in bed or sit comfortably during the monitoring period. They may experience minor discomfort from electrodes but can move around within a limited range. Pain management and comfort measures are minimal, as the procedure is generally non-invasive and painless. The continuous presence of healthcare professionals helps ensure patient safety and address any discomfort promptly.

Medical Policies and Guidelines for Electroencephalogram with video (VEEG), review of data, technical description by EEG technologist, each increment of 12-26 hours; with continuous, real-time monitoring and maintenance

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