CPT® Code 93232

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1. Indications

The wearable electrocardiographic rhythm-derived monitoring procedure is indicated for various clinical scenarios where continuous assessment of cardiac activity is necessary. The following conditions may warrant the use of this monitoring technique:

• Evaluation of Arrhythmias - This procedure is often performed to assess patients who exhibit symptoms of arrhythmias, such as palpitations, dizziness, or syncope, allowing for the identification of irregular heart rhythms.
• Assessment of Cardiac Symptoms - Patients presenting with unexplained chest pain or shortness of breath may require this monitoring to determine if their symptoms correlate with any abnormal heart activity.
• Post-Myocardial Infarction Monitoring - Following a heart attack, continuous monitoring can help evaluate the heart's recovery and detect any potential complications, such as arrhythmias.
• Preoperative Assessment - In certain cases, patients undergoing surgical procedures may need this monitoring to ensure their cardiac status is stable prior to surgery.

2. Procedure

The procedure for wearable electrocardiographic rhythm-derived monitoring involves several key steps to ensure accurate data collection and analysis. The following outlines the procedural steps:

• Step 1: Patient Preparation - The patient is prepared for the procedure by having electrodes or leads placed on their chest. This placement is crucial for capturing the electrical signals of the heart accurately. The healthcare provider instructs the patient on how to wear the Holter monitor and explains the importance of maintaining normal daily activities during the monitoring period.
• Step 2: Device Connection - Once the electrodes are in place, the Holter monitor is connected to the patient. The device is designed to continuously record the heart's electrical activity for a full 24 hours. The patient is advised to keep a diary of their activities and any symptoms experienced during this time, which can aid in correlating the recorded data with their daily activities.
• Step 3: Continuous Monitoring - Throughout the 24-hour period, the Holter monitor captures original ECG waveforms, storing the data on a magnetic tape or digitized medium. This continuous recording allows for a comprehensive analysis of the heart's rhythm and rate, as well as other parameters such as ST segment changes and heart rate variability.
• Step 4: Device Removal - After the 24-hour monitoring period, the patient returns to the healthcare facility to have the Holter monitor removed. The healthcare provider ensures that the device is properly disconnected and that all data has been successfully recorded.
• Step 5: Data Analysis - The stored data undergoes microprocessor-based analysis, which generates a detailed report. This report includes a miniaturized printout of the entire recording and selective sampling of rhythm strips, providing a comprehensive overview of the patient's cardiac activity during the monitoring period.

3. Post-Procedure

After the completion of the wearable electrocardiographic rhythm-derived monitoring, the patient may receive instructions regarding the next steps based on the analysis of the recorded data. The physician will review the report generated from the microprocessor-based analysis, which includes insights into the heart's rhythm and any identified arrhythmias. Depending on the findings, further diagnostic testing or treatment options may be discussed with the patient. It is essential for the patient to follow up with their healthcare provider to interpret the results and determine any necessary interventions or lifestyle modifications. The overall recovery from the procedure is typically straightforward, as it is non-invasive and does not require any significant downtime.