CPT® Code 99185

Deleted

1. Indications

Hypothermia of a single body region is indicated in specific clinical scenarios where there is a need to protect tissues from ischemic damage. The following conditions may warrant the use of this procedure:

• Ischemia - A condition where blood flow to a particular area is reduced or interrupted, necessitating intervention to preserve tissue viability.
• Trauma - Situations involving severe injury that may compromise blood supply to a limb, where hypothermia can help mitigate tissue damage.
• Revascularization procedures - Surgical interventions aimed at restoring blood flow, where hypothermia may be employed to protect the tissues during the process.

2. Procedure

The procedure for inducing regional hypothermia involves several critical steps to ensure the safety and effectiveness of the treatment. Each step is designed to carefully control the temperature of the targeted body region.

• Step 1: Patient Preparation The patient is assessed for suitability for the procedure, including a thorough evaluation of their medical history and current condition. Informed consent is obtained, and the patient is positioned comfortably to allow access to the affected area.
• Step 2: Application of Cooling Mechanism A cooling device or method is applied to the specific body region. This may involve the use of ice packs, cooling blankets, or specialized equipment designed to lower the temperature of the tissue effectively. The physician monitors the temperature closely to ensure it reaches the desired level without causing harm.
• Step 3: Monitoring Throughout the procedure, the patient's vital signs and the temperature of the targeted area are continuously monitored. This is crucial to prevent complications such as excessive cooling or hypothermia in adjacent tissues.
• Step 4: Duration of Hypothermia The physician determines the appropriate duration for maintaining the hypothermic state based on the clinical scenario and the patient's response. This duration is carefully managed to balance the benefits of reduced metabolism with the risks of prolonged exposure to cold.
• Step 5: Rewarming After the procedure, the targeted area is gradually rewarmed to normal body temperature. This step is essential to restore normal metabolic function and blood flow to the region, and it is done under careful monitoring to avoid complications.

3. Post-Procedure

Post-procedure care involves monitoring the patient for any adverse effects resulting from the hypothermia. The physician assesses the rewarming process to ensure that the tissues are returning to normal temperature without complications. Patients may require additional interventions based on their response to the procedure, including pain management and further evaluation of blood flow to the previously ischemic area. Follow-up assessments are critical to determine the success of the procedure in preserving tissue viability and function.