CPT® Code 93150

1. Indications

The procedure associated with CPT® Code 93150 is indicated for patients diagnosed with moderate to severe central sleep apnea (CSA). The following conditions and factors may contribute to the necessity of this procedure:

• Moderate to Severe Central Sleep Apnea (CSA) - A condition where the brain intermittently fails to send signals to the muscles that control breathing, leading to disrupted sleep and potential health complications.
• Cardiovascular Disease - Patients with existing heart conditions may experience exacerbated symptoms of CSA, necessitating the use of a phrenic nerve stimulator.
• Stroke - Individuals who have suffered a stroke may have impaired respiratory control, making them candidates for this therapy.
• Conditions Affecting the Neck or Brainstem - Any medical issues impacting the areas of the brain responsible for breathing regulation can lead to CSA.
• Morbid Obesity - Excess weight can contribute to respiratory difficulties during sleep, increasing the likelihood of CSA.
• Use of Narcotics - Patients who are on narcotic medications may experience respiratory depression, which can lead to CSA.

2. Procedure

The procedure for activating the implanted phrenic nerve stimulator system involves several critical steps to ensure proper functionality and therapeutic effectiveness:

• Initial Device Activation - Following the surgical implantation of the phrenic nerve stimulator, the device is turned on to begin data collection. This activation occurs approximately one month prior to the programming session, allowing the device to gather essential information regarding the patient's breathing patterns.
• Data Interrogation - During the programming session, the collected data is interrogated to evaluate the patient's historical breathing patterns. This analysis is crucial for determining the optimal stimulation parameters needed for effective treatment.
• Parameter Configuration - Based on the interrogation results, specific parameters such as respiration rate, pulse amplitude, pulse duration, and stimulation impedance timing are configured. These settings are tailored to the individual patient's needs to ensure effective stimulation of the diaphragm.
• Electrode Selection and Compliance Check - The procedure includes assessing the battery status and selecting the appropriate electrode(s) for stimulation. Additionally, patient compliance with the implanted lead(s) is evaluated to ensure the device functions as intended.
• Establishing Stimulation Limits - Finally, the initial settings for the upper and lower limits of pulse stimulation, as well as the rate and duration of stimulation, are established. This configuration is essential for optimizing the therapeutic effects of the phrenic nerve stimulator.

3. Post-Procedure

After the activation and programming of the phrenic nerve stimulator system, patients may require follow-up care to monitor the effectiveness of the therapy. It is essential to assess the patient's response to the stimulation and make any necessary adjustments to the programmed parameters. Regular follow-up appointments may be scheduled to evaluate the device's performance, check battery status, and ensure that the patient is compliant with the treatment regimen. Patients should be educated on the importance of reporting any changes in their sleep patterns or respiratory function, as these may indicate the need for further adjustments or interventions. Overall, the post-procedure phase is critical for ensuring the long-term success of the therapy and improving the patient's quality of life.