Electronic analysis of implanted neurostimulator pulse generator/transmitter (eg, contact group[s], interleaving, amplitude, pulse width, frequency [Hz], on/off cycling, burst, magnet mode, dose lockout, patient selectable parameters, responsive neurostim

CPT4 code

Name of the Procedure:

Electronic Analysis of Implanted Neurostimulator Pulse Generator/Transmitter (Common names: Neurostimulator Check, Programming Adjustment)

Summary

This procedure involves electronically checking and adjusting an implanted neurostimulator device, which is used to manage various neurological conditions. The analysis includes evaluating and modifying settings such as contact group settings, amplitude, pulse width, frequency, and cycling patterns.

Purpose

The procedure addresses neurological conditions managed by neurostimulation, such as chronic pain, Parkinson’s disease, or epilepsy. The goal is to ensure the neurostimulator is functioning optimally to deliver therapeutic relief and to personalize settings according to the patient's needs.

Indications

Chronic pain unresponsive to other treatments
Parkinson’s disease with medication-resistant symptoms
Epilepsy with frequent seizures
Patients with an existing implanted neurostimulator who require adjustments for improved symptom control

Preparation

Patients may need to fast if sedation is required.
Continue or pause certain medications as advised by the physician.
Complete any required diagnostic tests or assessments like imaging studies.

Procedure Description

The patient is positioned comfortably.
The healthcare provider uses a specialized programmer to communicate with the neurostimulator.
Several parameters are analyzed and adjusted, including contact groups, amplitude, pulse width, frequency, and cycling patterns.
Patient feedback may be used to fine-tune the settings to maximize symptom relief.

Duration

Typically, the procedure takes between 30 minutes to 1 hour.

Setting

The procedure is usually performed in a hospital, outpatient clinic, or a specialized neurology center.

Personnel

Neurologist or specialized physician
Nurse or technician
Anesthesiologist, if sedation is used

Risks and Complications

Minor discomfort or pain at the implant site.
Temporary increase in symptoms as settings are adjusted.
Risk of infection at the site of the neurostimulator.
Device malfunction or need for reprogramming.

Benefits

Improved control over symptoms such as pain or seizures.
Personalization of neurostimulator settings to better match patient needs.
Immediate adjustments can provide rapid symptom relief.

Recovery

Minimal recovery time; patients can usually go home the same day.
Follow-up appointment may be scheduled to reassess and fine-tune settings.
Avoid strenuous activities for a short period as advised by the healthcare provider.

Alternatives

Medication adjustments
Physical therapy for pain management
Surgery for severe cases
Pros and cons vary; alternatives may not offer the same level of immediate symptom relief.

Patient Experience

Patients might experience mild discomfort during the procedure.
Pain management options are available if necessary.
Most patients report noticeable improvement in symptoms soon after the procedure.