Name of the Procedure:

Phototherapy (Bilirubin) Light with Photometer (HCPCS E0202) Common name: Phototherapy for neonatal jaundice Technical term: Phototherapy with bilirubin light using a photometer

Summary

Phototherapy is a medical treatment used to lower high levels of bilirubin in the blood of newborns, a condition known as neonatal jaundice. The baby is placed under special blue lights that help break down excess bilirubin so it can be more easily processed and eliminated by the body.

Purpose

Phototherapy treats neonatal jaundice, which is common in newborns. The goal is to reduce bilirubin levels to prevent the risk of bilirubin-induced neurological dysfunction (BIND) or kernicterus, both severe complications.

Indications

• Elevated bilirubin levels (hyperbilirubinemia) as indicated by blood tests.
• Visible yellowing of the skin and eyes (jaundice).
• Prematurity or other factors that make the baby more susceptible to jaundice.

Preparation

• No significant preparation is usually required.
• Diagnostic blood tests to measure bilirubin levels.
• Regular breastfeeding or formula feeding should continue to ensure proper hydration.

Procedure Description

1. The baby is undressed to maximize skin exposure.
2. Protective eye patches are placed on the baby to shield their eyes from the light.
3. The baby is placed under a phototherapy lamp or on a phototherapy blanket (biliblanket) emitting blue light.
4. The intensity of the light is measured with a photometer to ensure optimal settings.
5. Regular monitoring of the baby's temperature, hydration, and bilirubin levels is performed.
6. Phototherapy sessions can last anywhere from a few hours to several days, with periodic breaks for feeding and bonding.

Duration

The procedure can range from several hours to a few days, depending on the severity of the jaundice and the bilirubin levels.

Setting

Phototherapy is usually performed in a hospital's neonatal unit but can sometimes be conducted at home with proper equipment and guidance.

Personnel

• Pediatricians
• Neonatologists (specialists in newborn care)
• Nurses

Risks and Complications

• Mild skin rash
• Dehydration
• Overheating
• Temporary bronze discoloration of the skin (rare)
• Eye damage if not properly protected

Benefits

• Rapid reduction of bilirubin levels.
• Prevention of severe complications like kernicterus.
• Improvement in baby's overall health and well-being.

Recovery

• Post-procedure monitoring of bilirubin levels to ensure they remain low.
• Regular feeding to maintain hydration.
• Most babies recover fully within a few days.
• Follow-up appointments with the pediatrician to track bilirubin levels and overall health.

Alternatives

• Exchange transfusion in severe cases, where baby's blood is replaced with donor blood.
• Intravenous immunoglobulin (IVIG) for babies whose jaundice is caused by blood group incompatibility.
• Ensuring adequate feeding and hydration to help naturally lower bilirubin levels.

Patient Experience

• The baby might experience mild discomfort due to eye patches and the necessity to remain under the lights.
• Sufficient feeding and hydration are crucial to comfort.
• Parents are encouraged to maintain physical contact with their baby during light-based therapy breaks.
• Pain management is generally not required, but attention to baby's comfort and regular monitoring is essential.