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Selective head hypothermia is a medical procedure specifically designed for neonates who are 28 days of age or younger, particularly those diagnosed with hypoxic-ischemic encephalopathy (HIE). HIE is a serious condition that arises from a lack of oxygen to the brain and spinal cord, often due to perinatal asphyxia, which can occur during labor and delivery. The procedure involves cooling either the entire body or just the head of the neonate to a temperature range of 91.4°F (33°C) to 93.2°F (34°C). This cooling process is most effective when initiated within six hours of birth, as it can significantly mitigate the neurological damage associated with HIE. The cooling is typically maintained for a duration of 72 hours, during which the infant's temperatures are meticulously monitored through various methods, including rectal, nasopharyngeal, scalp, and abdominal skin temperature assessments. Additionally, vital metabolic, cardiovascular, pulmonary, and coagulation laboratory measurements are taken at specified intervals to ensure the neonate's safety and response to the treatment. Following the cooling period, the procedure includes a gradual rewarming phase that lasts approximately four hours, allowing the infant to return to normal body temperature in a controlled manner. For billing purposes, CPT® Code 0261T is utilized to report each day of selective head hypothermia performed using a cooling helmet on eligible neonates.
© Copyright 2025 Coding Ahead. All rights reserved.
Hypoxic-Ischemic Encephalopathy (HIE) The primary indication for performing selective head hypothermia is the treatment of neonates diagnosed with hypoxic-ischemic encephalopathy (HIE), a condition that results from inadequate oxygen supply to the brain and spinal cord during the perinatal period.
Step 1: Initiation of Hypothermia The procedure begins with the identification of a neonate who meets the criteria for selective head hypothermia, particularly those diagnosed with HIE. Once the decision is made to proceed, the cooling process is initiated as soon as possible, ideally within six hours of delivery, to maximize the therapeutic benefits.
Step 2: Application of Cooling Helmet A specialized cooling helmet is then fitted onto the neonate's head. This helmet is designed to facilitate the selective cooling of the head while allowing the rest of the body to maintain a normal temperature. The cooling helmet is connected to a cooling system that regulates the temperature to the specified range of 91.4°F (33°C) to 93.2°F (34°C).
Step 3: Continuous Temperature Monitoring Throughout the cooling period, the neonate's temperature is continuously monitored using various methods, including rectal, nasopharyngeal, scalp, and abdominal skin temperature assessments. This continuous monitoring is crucial to ensure that the target temperature is maintained and to prevent any potential complications associated with hypothermia.
Step 4: Laboratory Assessments In addition to temperature monitoring, metabolic, cardiovascular, pulmonary, and coagulation laboratory measurements are conducted at predefined intervals. These assessments help in evaluating the neonate's overall health and response to the hypothermia treatment, allowing for timely interventions if necessary.
Step 5: Duration of Cooling The selective head hypothermia is maintained for a total duration of 72 hours. During this time, the medical team closely observes the neonate for any signs of distress or adverse reactions to the treatment.
Step 6: Rewarming Phase After the cooling period is complete, the procedure transitions to the rewarming phase. This phase involves a gradual rewarming of the neonate over approximately four hours. The rewarming process is carefully controlled to ensure that the infant's body temperature returns to normal levels without causing any sudden changes that could lead to complications.
Post-procedure care involves continued monitoring of the neonate's vital signs and neurological status following the rewarming phase. Healthcare providers will assess the infant for any potential complications that may arise from the hypothermia treatment. Additionally, ongoing evaluations of metabolic, cardiovascular, pulmonary, and coagulation parameters will be conducted to ensure the neonate's stability and recovery. The medical team will also provide supportive care as needed, which may include feeding and hydration support, as well as addressing any other medical needs that arise during the recovery period.
| Short Descr | HYPTHRM HEAD NEONATE 28D/ | Medium Descr | SELECT HEAD HYPOTHER NEONATE AGE 28 DAYS/ | Long Descr | Selective head hypothermia, per day, in the neonate 28 days of age or younger | Status Code | Carriers Price the Code | Global Days | YYY - Carrier Determines Whether Global Concept Applies | 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 | Items and Services Packaged into APC Rates | Type of Service (TOS) | 1 - Medical Care | Berenson-Eggers TOS (BETOS) | none | MUE | Not applicable/unspecified. | CCS Clinical Classification | 231 - Other therapeutic procedures |
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