CPT® Code 0639T

Official Description

Wireless skin sensor thermal anisotropy measurement(s) and assessment of flow in cerebrospinal fluid shunt, including ultrasound guidance, when performed

Common Language Description

The CPT® Code 0639T refers to a procedure involving the use of a wireless skin sensor to measure thermal anisotropy and assess the flow in cerebrospinal fluid (CSF) shunts. This procedure is particularly relevant for patients diagnosed with hydrocephalus, a condition characterized by an accumulation of cerebrospinal fluid in the brain. To manage this condition, a shunt system is typically implanted to facilitate the drainage of excess fluid. However, diagnosing malfunctions in these shunt systems can be challenging, as traditional diagnostic methods such as CT scans, MRI, nuclear medicine imaging, or exploratory surgery may be required to assess shunt patency. The wireless monitoring system described in this code offers a noninvasive alternative, allowing for continuous monitoring of CSF flow and shunt functionality. The system comprises a small, flexible skin sensor that adheres to the skin surface, typically located at the neck or clavicle where the shunt is most accessible. This sensor contains a thin, flexible circuit board equipped with thermal sensors, actuators, and a Bluetooth low-energy chip that enables data transmission to a smartphone application. The thermal actuator generates a controlled increase in temperature at the skin surface, and the resulting temperature variations downstream and upstream from the actuator are recorded. These measurements are crucial for calculating the flow of CSF through the shunt, providing valuable insights into its operational status without the need for invasive procedures.

1. Indications

The wireless skin sensor thermal anisotropy measurement and assessment of flow in cerebrospinal fluid shunt is indicated for patients with hydrocephalus who require monitoring of shunt patency and cerebrospinal fluid flow. This procedure is particularly beneficial when traditional diagnostic methods are inadequate or when there is a suspicion of shunt malfunction.

Hydrocephalus - A condition characterized by the accumulation of cerebrospinal fluid in the brain, necessitating the use of a shunt for drainage.
Shunt Malfunction - Situations where there is a need to assess the functionality of an implanted shunt system due to potential blockages or failures.

2. Procedure

The procedure involves several key steps to ensure accurate measurement and assessment of cerebrospinal fluid flow through the shunt system.

Preparation of the Skin Site - The area of the skin where the shunt is most superficial, typically the neck or clavicle, is prepared by cleaning and ensuring it is free of any contaminants to facilitate proper adhesion of the sensor.
Application of the Wireless Skin Sensor - A small, flexible skin sensor is gently molded and bonded onto the prepared skin surface. This sensor is designed to be unobtrusive and comfortable for the patient.
Activation of the Sensor - Once the sensor is in place, it is activated to begin monitoring. The thermal actuator within the sensor generates a controlled increase in temperature at the skin surface.
Data Collection - The thermal sensors within the device record temperature variations downstream and upstream from the actuator. These measurements are taken over time to assess the flow of cerebrospinal fluid through the shunt.
Data Transmission - The collected data is digitized and transmitted via Bluetooth to a smartphone application, allowing for real-time monitoring and analysis of the shunt's functionality.

3. Post-Procedure

After the procedure, the patient may be monitored for any immediate reactions to the sensor application. Continuous monitoring of the data through the smartphone application allows healthcare providers to assess the shunt's performance over time. Patients should be advised to report any unusual symptoms or changes in their condition, as these may indicate potential issues with the shunt. Regular follow-up appointments may be scheduled to review the data collected and make any necessary adjustments to the patient's treatment plan.

Short Descr	WRLS SKN SNR ANISOTROPY MEAS
Medium Descr	WIRELESS SKIN SNR THERMAL ANISOTROPY MEAS&ASSMT
Long Descr	Wireless skin sensor thermal anisotropy measurement(s) and assessment of flow in cerebrospinal fluid shunt, including ultrasound guidance, when performed
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	Non-Covered Service, not paid under OPPS
Berenson-Eggers TOS (BETOS)	none
MUE	1