CPT® Code 93745

1. Indications

The wearable cardioverter-defibrillator (WCD) is indicated for use in patients who are at risk for sudden cardiac arrest due to various cardiac conditions. The specific indications for the procedure include:

• Myocardial Infarction Patients who have recently experienced a heart attack may require monitoring to prevent sudden cardiac events.
• Coronary Artery Bypass Surgery Individuals who have undergone this surgical procedure may be at increased risk for arrhythmias and sudden cardiac arrest.
• Percutaneous Coronary Intervention This includes procedures such as angioplasty, atherectomy, or stent placement, which may leave patients vulnerable to cardiac complications.
• Other Risks for Sudden Cardiac Arrest Patients with additional risk factors for sudden cardiac arrest may also be candidates for the WCD, even if they have not experienced a recent cardiac event.

2. Procedure

The procedure for the initial set-up and programming of the wearable cardioverter-defibrillator involves several critical steps:

• Step 1: Patient Connection The healthcare professional begins by connecting the patient to an electrocardiogram (ECG) monitor. This connection is essential for real-time monitoring of the patient's cardiac rhythm and ensures accurate data collection during the procedure.
• Step 2: Establishing Connection Next, a connection is established between the wearable cardioverter-defibrillator system and the programming device. This step is crucial for the programming of the device and for setting the parameters that will guide its operation.
• Step 3: Baseline Programming The healthcare provider assesses the cardiac rhythm and performs baseline programming of the WCD. This involves configuring the device to recognize the patient's normal heart rhythm and to identify any deviations that may indicate a problem.
• Step 4: Patient Instruction After the programming is complete, the patient receives detailed instructions on how to wear the device properly. This includes guidance on the importance of data transmission to the healthcare provider and the necessity of reporting any problems or cardiac events that may occur.
• Step 5: Data Transmission The device is programmed to transmit data as needed, allowing for continuous monitoring of the patient's cardiac rhythm. Stored data related to cardiac rhythm and any episodes of tachyarrhythmia are reviewed to ensure the device is functioning correctly and to assess the patient's condition.

3. Post-Procedure

Post-procedure care involves ongoing monitoring of the patient’s cardiac rhythm through the wearable cardioverter-defibrillator. The patient is expected to wear the device as instructed and to maintain communication with their healthcare provider regarding any issues or symptoms experienced. Regular follow-up appointments may be scheduled to review the transmitted data and to make any necessary adjustments to the device settings. The healthcare provider will also assess the patient's overall condition and determine if further interventions are needed based on the data collected from the WCD.