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Electroconvulsive therapy (ECT) is a medical procedure that involves the application of electric currents to the brain to induce a controlled seizure. This therapeutic approach is primarily utilized to treat severe mental health conditions, including major depressive disorder, schizophrenia, mania, and catatonia. The underlying principle of ECT is to facilitate chemical changes in the brain that can alleviate the symptoms associated with these mental illnesses. During the procedure, the patient is placed under general anesthesia to ensure comfort and safety. Electrode pads are strategically positioned on the patient's head, either on one side (unilateral) or both sides (bilateral), to deliver the electric currents effectively. To prevent muscle paralysis during the seizure, a muscle relaxant is administered intravenously, and a blood pressure cuff is applied to the ankle or forearm. This cuff serves to monitor muscle activity and ensure that the seizure is occurring as intended. The physician carefully controls the amount of current delivered through the electrodes, aiming to produce a seizure lasting between 30 to 60 seconds. Throughout the procedure, the physician monitors the patient's response by observing movements in the cuffed extremity and analyzing the increased brain activity displayed on an electroencephalogram (EEG). Many patients experience significant improvement in their symptoms after just two or three ECT sessions, and the efficacy of the treatment often increases with multiple sessions.
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Electroconvulsive therapy (ECT) is indicated for several severe mental health conditions. The following are the primary indications for this procedure:
The procedure for electroconvulsive therapy (ECT) involves several critical steps to ensure patient safety and the effectiveness of the treatment. The following outlines the procedural steps:
Post-procedure care for patients who have undergone electroconvulsive therapy (ECT) includes monitoring for any immediate side effects, such as confusion or temporary memory loss, which are common after the treatment. Patients are typically observed in a recovery area until they are fully awake and stable. It is essential to provide reassurance and support during this time, as patients may feel disoriented. Follow-up appointments are scheduled to assess the effectiveness of the treatment and to determine if additional ECT sessions are necessary. Patients are advised to have a responsible adult accompany them home due to the lingering effects of anesthesia. Ongoing evaluation of the patient's mental health status is crucial to ensure that the treatment goals are being met and to make any necessary adjustments to the treatment plan.
| Short Descr | ELECTROCONVULSIVE THERAPY | Medium Descr | ELECTROCONVULSIVE THERAPY | Long Descr | Electroconvulsive therapy (includes necessary monitoring) | Status Code | Active Code | Global Days | 000 - Endoscopic or Minor Procedure | 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 | Procedure or Service, Not Discounted when Multiple | Type of Service (TOS) | 1 - Medical Care | Berenson-Eggers TOS (BETOS) | P1G - Major procedure - Other | MUE | 2 | CCS Clinical Classification | 218 - Psychological and psychiatric evaluation and therapy |
| GC | This service has been performed in part by a resident under the direction of a teaching physician | AM | Physician, team member service | CR | Catastrophe/disaster related | QJ | Services/items provided to a prisoner or patient in state or local custody, however the state or local government, as applicable, meets the requirements in 42 cfr 411.4 (b) | U6 | Medicaid level of care 6, as defined by each state | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | GW | Service not related to the hospice patient's terminal condition | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter | XP | Separate practitioner, a service that is distinct because it was performed by a different practitioner | GZ | Item or service expected to be denied as not reasonable and necessary | 22 | Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service. | 25 | Significant, separately identifiable evaluation and management service by the same physician or other qualified health care professional on the same day of the procedure or other service: it may be necessary to indicate that on the day a procedure or service identified by a cpt code was performed, the patient's condition required a significant, separately identifiable e/m service above and beyond the other service provided or beyond the usual preoperative and postoperative care associated with the procedure that was performed. a significant, separately identifiable e/m service is defined or substantiated by documentation that satisfies the relevant criteria for the respective e/m service to be reported (see evaluation and management services guidelines for instructions on determining level of e/m service). the e/m service may be prompted by the symptom or condition for which the procedure and/or service was provided. as such, different diagnoses are not required for reporting of the e/m services on the same date. this circumstance may be reported by adding modifier 25 to the appropriate level of e/m service. note: this modifier is not used to report an e/m service that resulted in a decision to perform surgery. see modifier 57 for significant, separately identifiable non-e/m services, see modifier 59. | 53 | Discontinued procedure: under certain circumstances, the physician or other qualified health care professional may elect to terminate a surgical or diagnostic procedure. due to extenuating circumstances or those that threaten the well being of the patient, it may be necessary to indicate that a surgical or diagnostic procedure was started but discontinued. this circumstance may be reported by adding modifier 53 to the code reported by the individual for the discontinued procedure. note: this modifier is not used to report the elective cancellation of a procedure prior to the patient's anesthesia induction and/or surgical preparation in the operating suite. for outpatient hospital/ambulatory surgery center (asc) reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 77 | Repeat procedure by another physician or other qualified health care professional: it may be necessary to indicate that a basic procedure or service was repeated by another physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 77 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 95 | Synchronous telemedicine service rendered via a real-time interactive audio and video telecommunications system: synchronous telemedicine service is defined as a real-time interaction between a physician or other qualified health care professional and a patient who is located at a distant site from the physician or other qualified health care professional. the totality of the communication of information exchanged between the physician or other qualified health care professional and the patient during the course of the synchronous telemedicine service must be of an amount and nature that would be sufficient to meet the key components and/or requirements of the same service when rendered via a face-to-face interaction. modifier 95 may only be appended to the services listed in appendix p. appendix p is the list of cpt codes for services that are typically performed face-to-face, but may be rendered via a real-time (synchronous) interactive audio and video telecommunications system. | AF | Specialty physician | AG | Primary physician | AI | Principal physician of record | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | AT | Acute treatment (this modifier should be used when reporting service 98940, 98941, 98942) | GA | Waiver of liability statement issued as required by payer policy, individual case | GT | Via interactive audio and video telecommunication systems | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | KX | Requirements specified in the medical policy have been met | SA | Nurse practitioner rendering service in collaboration with a physician | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| 2006-01-01 | Changed | Code description changed. |
| Pre-1990 | Added | Code added. |
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