Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude, pulse duration, configuration of wave form, battery status, electrode selectability, output modulation, cycling, impedance and patient compliance measureme
CPT4 code
Name of the Procedure:
Electronic Analysis of Implanted Neurostimulator Pulse Generator System
Common Names: Neurostimulator Check-Up, Neurostimulator Programming, Implantable Pulse Generator (IPG) Analysis
Summary
This procedure involves evaluating and adjusting a neurostimulator implanted in a patient. The neurostimulator controls nerve signals and can be adjusted for various settings like pulse rate, amplitude, and duration to optimize pain relief or control neurological symptoms.
Purpose
The procedure addresses chronic pain, movement disorders like Parkinson's disease, and other neurological conditions managed by nerve stimulation.
- Goals: To ensure the neurostimulator is functioning properly, to optimize its settings for maximum therapeutic benefit, and to check the device's battery status.
Indications
This procedure is warranted for:
- Patients experiencing inadequate symptom relief despite having an implanted neurostimulator.
- Those who experience changes in symptoms or side effects.
- Routine maintenance check-ups.
- Suspicion of device malfunction.
Preparation
- Patients should follow specific dietary or medication instructions provided by their healthcare provider.
- Typically, no special preparation is needed unless sedation is planned.
- A full medical history and any recent symptom changes should be discussed with the healthcare provider.
Procedure Description
- The healthcare provider uses a programmer (a specialized computer) to communicate with the implanted neurostimulator.
- Various settings of the device, including pulse rate, amplitude, pulse duration, configuration of waveforms, battery status, electrode selectability, and more, are analyzed.
- Adjustments to the device's settings may be made to optimize symptom control.
- Impedance and patient compliance measurements are checked to ensure proper functioning.
- If necessary, adjustments are made to improve efficacy or manage side effects.
Duration
The procedure typically takes 30 to 60 minutes.
Setting
The procedure is usually carried out in an outpatient clinic or specialized medical office.
Personnel
- Neurologist or Pain Specialist
- Nurse or Medical Technician
- Occasionally an Anesthesiologist if sedation is required
Risks and Complications
- Minimal risks are involved, mostly related to minor discomfort from adjusting settings.
- Rarely, improper adjustments could exacerbate symptoms.
- Device malfunctions or failures might necessitate additional interventions.
Benefits
- Optimized symptom management for conditions like chronic pain and movement disorders.
- Immediate feedback and adjustments can offer rapid symptom relief.
Recovery
- Patients can resume normal activities almost immediately.
- Any specific post-procedure care will be discussed, though typically minimal.
- Follow-up appointments may be scheduled to monitor the device and symptoms.
Alternatives
- Physical therapy, medication adjustments, or other medical procedures.
- Pros: Non-invasive options.
- Cons: May not be as effective or provide symptom relief as quickly as neurostimulation.
Patient Experience
- During the procedure, patients might feel slight tingling as settings are adjusted.
- Overall, the procedure is generally well-tolerated with minimal discomfort.
- Pain management and comfort measures will be provided as needed.