CPT® Code 93237

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1. Indications

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

• Assessment of Arrhythmias - This procedure is utilized to evaluate patients who exhibit symptoms suggestive of arrhythmias, such as palpitations, dizziness, or syncope.
• Evaluation of Unexplained Symptoms - Patients presenting with unexplained symptoms that may be related to cardiac issues, including chest pain or shortness of breath, may benefit from this monitoring.
• Post-Myocardial Infarction Monitoring - Following a heart attack, continuous monitoring can help detect any arrhythmias that may arise during recovery.
• Preoperative Assessment - In certain cases, patients may require rhythm monitoring prior to surgical procedures to ensure cardiac stability.

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 from the heart accurately. The healthcare provider ensures that the skin is clean and free of oils or lotions to facilitate good electrode adhesion.
• Step 2: Device Instruction - The patient receives detailed instructions on how to use the Holter monitor. This includes guidance on how to activate the device if they experience symptoms, as well as information on daily activities to avoid that may interfere with the monitoring process.
• Step 3: Continuous Monitoring - The patient wears the monitoring device for a full 24-hour period. During this time, the device continuously records ECG signals, allowing for comprehensive monitoring of the heart's rhythm as the patient engages in their regular daily activities.
• Step 4: Data Analysis - The Holter monitor's computerized system analyzes the recorded ECG data in real-time. It classifies different ECG waveforms and flags any abnormal rhythms, which may prompt the device to produce intermittent full-sized waveform tracings or printouts of selected EKG rhythm strips.
• Step 5: Data Review - After the monitoring period, the recorded data is reviewed by a physician. The physician interprets the findings to assess for any arrhythmias or other cardiac abnormalities based on the stored data, which includes heart rhythm, rate, ST analysis, and T-wave alternans.

3. Post-Procedure

Post-procedure care for patients who have undergone wearable electrocardiographic rhythm-derived monitoring typically involves a follow-up consultation with the physician. During this follow-up, the physician discusses the results of the monitoring, including any identified arrhythmias or abnormalities. Depending on the findings, further diagnostic testing or treatment options may be recommended. Patients are advised to report any ongoing symptoms or new concerns that may arise after the monitoring period. Additionally, the physician may provide guidance on lifestyle modifications or medications if necessary, based on the interpretation of the data collected during the monitoring.