Name of the Condition

• Breakdown (mechanical) of implanted electronic neurostimulator of spinal cord electrode (lead), subsequent encounter

Summary

• This condition involves the mechanical failure of a neurostimulator device implanted in the spinal cord, which is used to manage chronic pain or other neurological conditions. The ICD code T85.112D refers specifically to issues with the electrode or lead component of the device upon subsequent encounters, meaning it denotes a follow-up or continued treatment phase after the initial diagnosis.

Causes

• The failure of the implanted device may result from wear and tear, manufacturing defects, surgical errors, or physical trauma to the site.

Risk Factors

• Risk is increased by factors such as previous complications from surgery, participation in high-impact activities, and underlying health conditions that impact healing or device integration.

Symptoms

• Patients may experience increased pain, loss of pain relief, unusual sensations, or localized swelling and redness at the site of the implant.

Diagnosis

• Diagnosing mechanical breakdown involves physical examination, imaging tests like X-rays or MRIs, and device interrogation to assess the functionality of the neurostimulator.

Treatment Options

• Treatments can include reprogramming the device, repairing or replacing the damaged component, and occasionally removing the device. Each treatment aims to restore proper function or relieve symptoms.

Prognosis and Follow-Up

• With proper treatment, many patients recover well, but the prognosis depends on the specific nature of the breakdown and patient health. Regular follow-up is crucial to monitor the device's functionality and manage any further complications.

Complications

• Potential complications include infection, worsening of symptoms, or permanent nerve damage if not addressed promptly.

Lifestyle & Prevention

• Patients can help manage their condition by avoiding activities that could physically impact the implant site and following post-operative care guidelines provided by their healthcare provider.

When to Seek Professional Help

• Immediate medical attention is necessary if the patient experiences abrupt increases in pain, signs of infection, or a complete loss of device functionality.

Additional Resources

• Patients can seek information and support from organizations like the American Chronic Pain Association (ACPA) or their healthcare provider for tailored advice.

Tips for Medical Coders

• Ensure the coding reflects the subsequent encounter nature of this condition. Avoid coding errors by checking that the condition is not listed as an initial encounter, and cross-reference device-specific codes for accuracy.