CPT® Code 0160T | Case2Code

Code deleted, see 90867, 90869.

Official Description

Therapeutic repetitive transcranial magnetic stimulation treatment planning

Common Language Description

Therapeutic repetitive transcranial magnetic stimulation (rTMS) treatment planning involves a comprehensive approach to address specific mental health issues by targeting particular areas of the brain. This procedure is designed to determine the most effective treatment parameters, including the specific brain region to be stimulated, the duration of the treatment, and the method of application. rTMS is utilized for various mental disorders, including depression, anxiety, obsessive-compulsive disorder, auditory hallucinations, and migraines. In these conditions, certain areas of the brain may exhibit abnormal activity; for example, individuals with depression often show reduced activity in the left prefrontal cortex. The rTMS technique involves the non-invasive application of an electrical current through the scalp and skull, which is painless. A specially designed wire, encased in plastic, is positioned on the head and energized by a discharge from a large capacitor, creating a rapidly changing current. This process generates a magnetic field that penetrates the skin and bone, inducing a current in the brain that stimulates nearby nerve cells similarly to direct electrical stimulation of the cortical surface. The therapy aims to modify the brain's biochemistry, neuronal firing patterns, and neurotransmitter levels, such as serotonin. When utilizing stereotactic MRI reference, the targeting of rTMS can achieve remarkable precision within a few millimeters. The magnetic pulses are typically administered for a few minutes each day over several weeks, with the treatment being delivered and managed in a structured manner during each session, as outlined in the subsequent CPT® code 0161T.

1. Indications

The therapeutic repetitive transcranial magnetic stimulation (rTMS) treatment planning is indicated for various mental health disorders, specifically targeting the following conditions:

Depression - rTMS is utilized to address the reduced activity in the left prefrontal cortex commonly associated with depressive disorders.
Anxiety - The treatment aims to modulate brain activity linked to anxiety disorders.
Obsessive-Compulsive Disorder (OCD) - rTMS is indicated for patients experiencing symptoms of OCD, targeting the relevant brain areas.
Auditory Hallucinations - The procedure is used to help manage auditory hallucinations by stimulating specific brain regions.
Migraines - rTMS is also indicated for the treatment of migraines, focusing on the areas of the brain involved in pain perception.

2. Procedure

The procedure for therapeutic repetitive transcranial magnetic stimulation (rTMS) treatment planning involves several key steps to ensure effective treatment delivery:

Step 1: Patient Assessment - A thorough evaluation of the patient's mental health condition is conducted to determine the appropriateness of rTMS. This includes reviewing the patient's medical history, current symptoms, and previous treatment responses.
Step 2: Target Area Identification - The specific area of the brain that requires stimulation is identified based on the patient's diagnosis. This may involve neuroimaging techniques, such as MRI, to visualize brain activity and pinpoint the target region.
Step 3: Treatment Parameter Determination - The clinician establishes the parameters for rTMS treatment, including the duration of each session, the frequency of treatments per week, and the total number of sessions required for optimal results.
Step 4: Equipment Setup - The rTMS device is prepared for use, ensuring that the coil is positioned correctly over the targeted area of the scalp. The device is calibrated to deliver the appropriate intensity and frequency of magnetic pulses.
Step 5: Treatment Administration - The rTMS treatment is administered, with the patient remaining comfortable and relaxed. The clinician monitors the patient throughout the session to ensure safety and efficacy.
Step 6: Post-Treatment Evaluation - After each session, the clinician assesses the patient's response to treatment, making any necessary adjustments to the treatment plan based on the patient's feedback and clinical observations.

3. Post-Procedure

Post-procedure care for therapeutic repetitive transcranial magnetic stimulation (rTMS) involves monitoring the patient for any immediate side effects, which are generally minimal and may include mild headache or scalp discomfort. Patients are typically advised to resume their normal activities immediately following the session, as rTMS is a non-invasive procedure with no recovery time required. Ongoing evaluations are essential to assess the effectiveness of the treatment and to make any necessary adjustments to the treatment plan. The overall treatment duration may span several weeks, with sessions scheduled multiple times per week, depending on the individual patient's needs and response to therapy.

Short Descr	TCRANIAL MAGN STIM TX PLAN
Medium Descr	TRANSCRANIAL MAG STIMJ TX PLANNING
Long Descr	Therapeutic repetitive transcranial magnetic stimulation treatment planning
Status Code	Carriers Price the Code
Global Days	XXX - Global Concept Does Not Apply
PC/TC Indicator (26, TC)	0 - Physician Service Code
Multiple Procedures (51)	0 - No payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50)	0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions	09 - Concept does not apply.
Assistant Surgeon (80, 82)	0 - Payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62)	0 - Co-surgeons not permitted for this procedure.
Team Surgery (66)	0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family	99 - Concept Does Not Apply
APC Status Indicator	Significant Procedure, Not Discounted When Multiple
Type of Service (TOS)	6 - Therapeutic Radiology
Berenson-Eggers TOS (BETOS)	none
MUE	Not applicable/unspecified.
CCS Clinical Classification	8 - Other non-OR or closed therapeutic nervous system procedures