L28793 CARDIAC OUTPUT MONITORING BY THORACIC ELECTRICAL BIOIMPEDANCE

 

 

10/01/2011

 

 

Indications and Limitations of Coverage and/or Medical Necessity

 

Cardiac output monitoring using electrical bioimpedance, a form of plethysmography, is covered by Medicare effective for services furnished on or after July 1, 1999.

 

These devices utilize electrical bioimpedance to noninvasively produce hemodynamic measurements of cardiac output, specifically stroke volume, contractility, systemic vascular resistance, and thoracic fluid content.

• These devices are covered for the following indications:

o Differentiation of cardiogenic from pulmonary causes of acute dyspnea when medical history, physical examination, and standard assessment tools provide insufficient information and the treating physician has determined that TEB hemodynamic data are necessary for appropriate management of the patient.

o Optimization of atrioventricular (A/V) interval for patients with A/V sequential cardiac pacemakers when medical history, physical examination, and standard assessment tools provide insufficient information and the treating physician has determined that TEB hemodynamic data are necessary for appropriate management of the patient.

o Monitoring of continuous inotropic therapy for patients with terminal congestive heart failure, when those patients have chosen to die with comfort at home, or for patients waiting at home for a heart transplant.

o Evaluation for rejection in patients with a heart transplant as a predetermined alternative to a myocardial biopsy. Medical necessity must be documented should a biopsy be performed after TEB.

o Optimization of fluid management in patients with congestive heart failure when medical history, physical examination, and standard assessment tools provide insufficient information, and the treating physician has determined that TEB hemodynamic data are necessary for appropriate management of the patient.

o Management of drug-resistant hypertension. (Drug resistant hypertension is defined as failure to achieve goal BP in patients who are adhering to full doses of an appropriate three-drug regimen that includes a diuretic.)

 

• The following are examples of appropriate clinical indications for which Medicare will consider the assessment of cardiac output by electrical bioimpedance medically reasonable and necessary:

o For patients with structural heart disease (with an ejection fraction £ 40%) associated with the development of congestive heart failure.

 Valvular and congenital.

 Post myocardial infarction.

 Rheumatic heart disease.

o For patients with inflammatory heart disease (with an ejection fraction £ 40%) associated with the development of congestive heart failure.

 Myocarditis and cardiomyopathy.

 Pericarditis and constrictive pericardial scarring.

 Rheumatic heart disease.

o For patients with ischemic heart disease (with an ejection fraction £ 40%) associated with the development of congestive heart failure.

 Post myocardial infarction.

 Ischemic cardiomyopathy.

 Ischemic mitral valve.

 Left ventricular dysfunction.

o For patients with cardiac disease resulting in congestive heart failure with normal left ventricular function.

 Diastolic dysfunction.

 Restrictive cardiomyopathy/infiltrative such as amyloidosis.

 Cancer of the heart.

o For patients with pulmonary disease associated with congestive heart failure.

 Cor pulmonale and the need to distinguish between pulmonary and cardiac disease as the cause.

 Pulmonary hypertension.

o For acute conditions for which the patient might present to an outpatient setting and in which a decision regarding intervention is necessary.

 Pericardial effusion with possible tamponade.

 Myocardial infarction.

 Cardiac trauma.

o For patients with recent pacemaker implants who demonstrate clinical manifestations of:

 Unexplained fatigue.

 Symptomatic hypotension.

 Congestive heart failure.

o For the titration of therapeutic agents in the setting of symptomatic congestive heart failure.

o For acute heart rejection during outpatient follow-up of heart transplant patients (as a supplement to invasive endomyocardial biopsy).

o For patients with acute/chronic renal failure or end stage renal disease/dialysis who demonstrate clinical manifestations of unexplained shortness of breath, unexplained reduced access flow, symptomatic hypotension/hypertension.

 

 

LIMITATIONS OF COVERAGE

 

• Cardiac output by electrical bioimpedance is not covered for the following indications:

o Monitoring of patients with proven or suspected disease involving severe regurgitation of the aorta.

o Patients with minute ventilation (MV) sensor function pacemakers. (since the device may adversely affect the functioning of that type of pacemaker).

o Cardiac bypass patients while on a cardiopulmonary bypass machine. (since the device does not render accurate measurements under this circumstance).

o The use of electrical bioimpedance for the routine assessment of hypertensive patient.

 

 

Coding Information

 

Bill Type Codes

 

• Contractors may specify Bill Types to help providers identify those Bill Types typically used to report this service.

• Absence of a Bill Type does not guarantee that the policy does not apply to that Bill Type.

• Complete absence of all Bill Types indicates that coverage is not influenced by Bill Type and the policy should be assumed to apply equally to all claims.

 

12x Hospital Inpatient (Medicare Part B only)

13x Hospital Outpatient

14x Hospital - Laboratory Services Provided to Non-patients

21x Skilled Nursing - Inpatient (Including Medicare Part A)

72x Clinic - Hospital Based or Independent Renal Dialysis Center

85x Critical Access Hospital

 

Revenue Codes

• Contractors may specify Revenue Codes to help providers identify those Revenue Codes typically used to report this service.

• In most instances Revenue Codes are purely advisory; unless specified in the policy services reported under other Revenue Codes are equally subject to this coverage determination.

• Complete absence of all Revenue Codes indicates that coverage is not influenced by Revenue Code and the policy should be assumed to apply equally to all Revenue Codes.

 

0920 Other Diagnostic Services - General Classification

0940 Other Therapeutic Services - General Classification

 

 

CPT/HCPCS Codes

 

93701 BIOIMPEDANCE-DERIVED PHYSIOLOGIC CARDIOVASCULAR ANALYSIS

 

 

ICD-9 Codes that Support Medical Necessity

 

391.0 ACUTE RHEUMATIC PERICARDITIS

391.1 ACUTE RHEUMATIC ENDOCARDITIS

391.2 ACUTE RHEUMATIC MYOCARDITIS

391.8 OTHER ACUTE RHEUMATIC HEART DISEASE

391.9 ACUTE RHEUMATIC HEART DISEASE UNSPECIFIED

394.0 MITRAL STENOSIS

394.1 RHEUMATIC MITRAL INSUFFICIENCY

394.2 MITRAL STENOSIS WITH INSUFFICIENCY

394.9 OTHER AND UNSPECIFIED MITRAL VALVE DISEASES

397.0 DISEASES OF TRICUSPID VALVE

397.1 RHEUMATIC DISEASES OF PULMONARY VALVE

397.9 RHEUMATIC DISEASES OF ENDOCARDIUM VALVE UNSPECIFIED

398.90 RHEUMATIC HEART DISEASE UNSPECIFIED

398.91 RHEUMATIC HEART FAILURE (CONGESTIVE)

401.0 MALIGNANT ESSENTIAL HYPERTENSION

401.9 UNSPECIFIED ESSENTIAL HYPERTENSION

402.00 MALIGNANT HYPERTENSIVE HEART DISEASE WITHOUT HEART FAILURE

402.01 MALIGNANT HYPERTENSIVE HEART DISEASE WITH HEART FAILURE

402.11 BENIGN HYPERTENSIVE HEART DISEASE WITH HEART FAILURE

402.91 UNSPECIFIED HYPERTENSIVE HEART DISEASE WITH HEART FAILURE

403.00 HYPERTENSIVE CHRONIC KIDNEY DISEASE, MALIGNANT, WITH CHRONIC KIDNEY DISEASE STAGE I THROUGH STAGE IV, OR UNSPECIFIED

403.01 HYPERTENSIVE CHRONIC KIDNEY DISEASE, MALIGNANT, WITH CHRONIC KIDNEY DISEASE STAGE V OR END STAGE RENAL DISEASE

403.11 HYPERTENSIVE CHRONIC KIDNEY DISEASE, BENIGN, WITH CHRONIC KIDNEY DISEASE STAGE V OR END STAGE RENAL DISEASE

403.91 HYPERTENSIVE CHRONIC KIDNEY DISEASE, UNSPECIFIED, WITH CHRONIC KIDNEY DISEASE STAGE V OR END STAGE RENAL DISEASE

404.00 HYPERTENSIVE HEART AND CHRONIC KIDNEY DISEASE, MALIGNANT, WITHOUT HEART FAILURE AND WITH CHRONIC KIDNEY DISEASE STAGE I THROUGH STAGE IV, OR UNSPECIFIED

404.01 HYPERTENSIVE HEART AND CHRONIC KIDNEY DISEASE, MALIGNANT, WITH HEART FAILURE AND WITH CHRONIC KIDNEY DISEASE STAGE I THROUGH STAGE IV, OR UNSPECIFIED

404.02 HYPERTENSIVE HEART AND CHRONIC KIDNEY DISEASE, MALIGNANT, WITHOUT HEART FAILURE AND WITH CHRONIC KIDNEY DISEASE STAGE V OR END STAGE RENAL DISEASE

404.03 HYPERTENSIVE HEART AND CHRONIC KIDNEY DISEASE, MALIGNANT, WITH HEART FAILURE AND WITH CHRONIC KIDNEY DISEASE STAGE V OR END STAGE RENAL DISEASE

404.11 HYPERTENSIVE HEART AND CHRONIC KIDNEY DISEASE, BENIGN, WITH HEART FAILURE AND WITH CHRONIC KIDNEY DISEASE STAGE I THROUGH STAGE IV, OR UNSPECIFIED

404.12 HYPERTENSIVE HEART AND CHRONIC KIDNEY DISEASE, BENIGN, WITHOUT HEART FAILURE AND WITH CHRONIC KIDNEY DISEASE STAGE V OR END STAGE RENAL DISEASE

404.13 HYPERTENSIVE HEART AND CHRONIC KIDNEY DISEASE, BENIGN, WITH HEART FAILURE AND CHRONIC KIDNEY DISEASE STAGE V OR END STAGE RENAL DISEASE

404.91 HYPERTENSIVE HEART AND CHRONIC KIDNEY DISEASE, UNSPECIFIED, WITH HEART FAILURE AND WITH CHRONIC KIDNEY DISEASE STAGE I THROUGH STAGE IV, OR UNSPECIFIED

404.92 HYPERTENSIVE HEART AND CHRONIC KIDNEY DISEASE, UNSPECIFIED, WITHOUT HEART FAILURE AND WITH CHRONIC KIDNEY DISEASE STAGE V OR END STAGE RENAL DISEASE

404.93 HYPERTENSIVE HEART AND CHRONIC KIDNEY DISEASE, UNSPECIFIED, WITH HEART FAILURE AND CHRONIC KIDNEY DISEASE STAGE V OR END STAGE RENAL DISEASE

405.01 MALIGNANT RENOVASCULAR HYPERTENSION

405.09 OTHER MALIGNANT SECONDARY HYPERTENSION

405.91 UNSPECIFIED RENOVASCULAR HYPERTENSION

405.99 OTHER UNSPECIFIED SECONDARY HYPERTENSION

410.00 ACUTE MYOCARDIAL INFARCTION OF ANTEROLATERAL WALL EPISODE OF CARE UNSPECIFIED

410.01 ACUTE MYOCARDIAL INFARCTION OF ANTEROLATERAL WALL INITIAL EPISODE OF CARE

410.02 ACUTE MYOCARDIAL INFARCTION OF ANTEROLATERAL WALL SUBSEQUENT EPISODE OF CARE

410.10 ACUTE MYOCARDIAL INFARCTION OF OTHER ANTERIOR WALL EPISODE OF CARE UNSPECIFIED

410.11 ACUTE MYOCARDIAL INFARCTION OF OTHER ANTERIOR WALL INITIAL EPISODE OF CARE

410.12 ACUTE MYOCARDIAL INFARCTION OF OTHER ANTERIOR WALL SUBSEQUENT EPISODE OF CARE

410.20 ACUTE MYOCARDIAL INFARCTION OF INFEROLATERAL WALL EPISODE OF CARE UNSPECIFIED

410.21 ACUTE MYOCARDIAL INFARCTION OF INFEROLATERAL WALL INITIAL EPISODE OF CARE

410.22 ACUTE MYOCARDIAL INFARCTION OF INFEROLATERAL WALL SUBSEQUENT EPISODE OF CARE

410.30 ACUTE MYOCARDIAL INFARCTION OF INFEROPOSTERIOR WALL EPISODE OF CARE UNSPECIFIED

410.31 ACUTE MYOCARDIAL INFARCTION OF INFEROPOSTERIOR WALL INITIAL EPISODE OF CARE

410.32 ACUTE MYOCARDIAL INFARCTION OF INFEROPOSTERIOR WALL SUBSEQUENT EPISODE OF CARE

410.40 ACUTE MYOCARDIAL INFARCTION OF OTHER INFERIOR WALL EPISODE OF CARE UNSPECIFIED

410.41 ACUTE MYOCARDIAL INFARCTION OF OTHER INFERIOR WALL INITIAL EPISODE OF CARE

410.42 ACUTE MYOCARDIAL INFARCTION OF OTHER INFERIOR WALL SUBSEQUENT EPISODE OF CARE

410.50 ACUTE MYOCARDIAL INFARCTION OF OTHER LATERAL WALL EPISODE OF CARE UNSPECIFIED

410.51 ACUTE MYOCARDIAL INFARCTION OF OTHER LATERAL WALL INITIAL EPISODE OF CARE

410.52 ACUTE MYOCARDIAL INFARCTION OF OTHER LATERAL WALL SUBSEQUENT EPISODE OF CARE

410.60 TRUE POSTERIOR WALL INFARCTION EPISODE OF CARE UNSPECIFIED

410.61 TRUE POSTERIOR WALL INFARCTION INITIAL EPISODE OF CARE

410.62 TRUE POSTERIOR WALL INFARCTION SUBSEQUENT EPISODE OF CARE

410.70 SUBENDOCARDIAL INFARCTION EPISODE OF CARE UNSPECIFIED

410.71 SUBENDOCARDIAL INFARCTION INITIAL EPISODE OF CARE

410.72 SUBENDOCARDIAL INFARCTION SUBSEQUENT EPISODE OF CARE

410.80 ACUTE MYOCARDIAL INFARCTION OF OTHER SPECIFIED SITES EPISODE OF CARE UNSPECIFIED

410.81 ACUTE MYOCARDIAL INFARCTION OF OTHER SPECIFIED SITES INITIAL EPISODE OF CARE

410.82 ACUTE MYOCARDIAL INFARCTION OF OTHER SPECIFIED SITES SUBSEQUENT EPISODE OF CARE

410.90 ACUTE MYOCARDIAL INFARCTION OF UNSPECIFIED SITE EPISODE OF CARE UNSPECIFIED

410.91 ACUTE MYOCARDIAL INFARCTION OF UNSPECIFIED SITE INITIAL EPISODE OF CARE

410.92 ACUTE MYOCARDIAL INFARCTION OF UNSPECIFIED SITE SUBSEQUENT EPISODE OF CARE

411.0 POSTMYOCARDIAL INFARCTION SYNDROME

411.1 INTERMEDIATE CORONARY SYNDROME

411.81 ACUTE CORONARY OCCLUSION WITHOUT MYOCARDIAL INFARCTION

411.89 OTHER ACUTE AND SUBACUTE FORMS OF ISCHEMIC HEART DISEASE OTHER

413.0 ANGINA DECUBITUS

413.1 PRINZMETAL ANGINA

413.9 OTHER AND UNSPECIFIED ANGINA PECTORIS

414.00 CORONARY ATHEROSCLEROSIS OF UNSPECIFIED TYPE OF VESSEL NATIVE OR GRAFT

414.01 CORONARY ATHEROSCLEROSIS OF NATIVE CORONARY ARTERY

414.02 CORONARY ATHEROSCLEROSIS OF AUTOLOGOUS VEIN BYPASS GRAFT

414.03 CORONARY ATHEROSCLEROSIS OF NONAUTOLOGOUS BIOLOGICAL BYPASS GRAFT

414.04 CORONARY ATHEROSCLEROSIS OF ARTERY BYPASS GRAFT

414.05 CORONARY ATHEROSCLEROSIS OF UNSPECIFIED BYPASS GRAFT

414.06 CORONARY ATHEROSCLEROSIS OF NATIVE CORONARY ARTERY OF TRANSPLANTED HEART

414.07 CORONARY ATHEROSCLEROSIS OF BYPASS GRAFT (ARTERY) (VEIN) OF TRANSPLANTED HEART

414.10 ANEURYSM OF HEART (WALL)

414.11 ANEURYSM OF CORONARY VESSELS

414.12 DISSECTION OF CORONARY ARTERY

414.19 OTHER ANEURYSM OF HEART

414.4 CORONARY ATHEROSCLEROSIS DUE TO CALCIFIED CORONARY LESION

414.8 OTHER SPECIFIED FORMS OF CHRONIC ISCHEMIC HEART DISEASE

415.0 ACUTE COR PULMONALE

415.11 IATROGENIC PULMONARY EMBOLISM AND INFARCTION

415.12 SEPTIC PULMONARY EMBOLISM

415.13 SADDLE EMBOLUS OF PULMONARY ARTERY

415.19 OTHER PULMONARY EMBOLISM AND INFARCTION

420.0 ACUTE PERICARDITIS IN DISEASES CLASSIFIED ELSEWHERE

420.90 ACUTE PERICARDITIS UNSPECIFIED

420.91 ACUTE IDIOPATHIC PERICARDITIS

420.99 OTHER ACUTE PERICARDITIS

421.0 ACUTE AND SUBACUTE BACTERIAL ENDOCARDITIS

421.1 ACUTE AND SUBACUTE INFECTIVE ENDOCARDITIS IN DISEASES CLASSIFIED ELSEWHERE

421.9 ACUTE ENDOCARDITIS UNSPECIFIED

422.0 ACUTE MYOCARDITIS IN DISEASES CLASSIFIED ELSEWHERE

422.90 ACUTE MYOCARDITIS UNSPECIFIED

422.91 IDIOPATHIC MYOCARDITIS

422.92 SEPTIC MYOCARDITIS

422.93 TOXIC MYOCARDITIS

422.99 OTHER ACUTE MYOCARDITIS

423.0 HEMOPERICARDIUM

423.1 ADHESIVE PERICARDITIS

423.2 CONSTRICTIVE PERICARDITIS

423.3 CARDIAC TAMPONADE

423.8 OTHER SPECIFIED DISEASES OF PERICARDIUM

423.9 UNSPECIFIED DISEASE OF PERICARDIUM

424.0 MITRAL VALVE DISORDERS

424.2 TRICUSPID VALVE DISORDERS SPECIFIED AS NONRHEUMATIC

424.3 PULMONARY VALVE DISORDERS

424.90 ENDOCARDITIS VALVE UNSPECIFIED UNSPECIFIED CAUSE

424.91 ENDOCARDITIS IN DISEASES CLASSIFIED ELSEWHERE

424.99 OTHER ENDOCARDITIS VALVE UNSPECIFIED

425.0 ENDOMYOCARDIAL FIBROSIS

425.11 HYPERTROPHIC OBSTRUCTIVE CARDIOMYOPATHY

425.18 OTHER HYPERTROPHIC CARDIOMYOPATHY

425.2 OBSCURE CARDIOMYOPATHY OF AFRICA

425.3 ENDOCARDIAL FIBROELASTOSIS

425.4 OTHER PRIMARY CARDIOMYOPATHIES

425.5 ALCOHOLIC CARDIOMYOPATHY

425.7 NUTRITIONAL AND METABOLIC CARDIOMYOPATHY

425.8 CARDIOMYOPATHY IN OTHER DISEASES CLASSIFIED ELSEWHERE

428.0 CONGESTIVE HEART FAILURE UNSPECIFIED

428.1 LEFT HEART FAILURE

428.20 UNSPECIFIED SYSTOLIC HEART FAILURE

428.21 ACUTE SYSTOLIC HEART FAILURE

428.22 CHRONIC SYSTOLIC HEART FAILURE

428.23 ACUTE ON CHRONIC SYSTOLIC HEART FAILURE

428.30 UNSPECIFIED DIASTOLIC HEART FAILURE

428.31 ACUTE DIASTOLIC HEART FAILURE

428.32 CHRONIC DIASTOLIC HEART FAILURE

428.33 ACUTE ON CHRONIC DIASTOLIC HEART FAILURE

428.40 UNSPECIFIED COMBINED SYSTOLIC AND DIASTOLIC HEART FAILURE

428.41 ACUTE COMBINED SYSTOLIC AND DIASTOLIC HEART FAILURE

428.42 CHRONIC COMBINED SYSTOLIC AND DIASTOLIC HEART FAILURE

428.43 ACUTE ON CHRONIC COMBINED SYSTOLIC AND DIASTOLIC HEART FAILURE

428.9 HEART FAILURE UNSPECIFIED

429.3 CARDIOMEGALY

429.4 FUNCTIONAL DISTURBANCES FOLLOWING CARDIAC SURGERY

429.83 TAKOTSUBO SYNDROME

430 SUBARACHNOID HEMORRHAGE

518.4 ACUTE EDEMA OF LUNG UNSPECIFIED

518.7 TRANSFUSION RELATED ACUTE LUNG INJURY (TRALI)

786.05 SHORTNESS OF BREATH

996.83 COMPLICATIONS OF TRANSPLANTED HEART

V42.1* HEART REPLACED BY TRANSPLANT

V53.31 FITTING AND ADJUSTMENT OF CARDIAC PACEMAKER

V53.32 FITTING AND ADJUSTMENT OF AUTOMATIC IMPLANTABLE CARDIAC DEFIBRILLATOR

* According to the ICD-9-CM book, diagnosis code V42.1 is a secondary diagnosis code and should not be billed as the primary diagnosis.

 

 

Documentation Requirements

 

• Medical record documentation (e.g., office/progress notes) maintained by the ordering/referring physician must indicate the medical necessity for assessment of cardiac output by electrical bioimpedance.

• Additionally, a copy of the measurements acquired through the use of the electrical bioimpedance device, with the physician's signature, must be maintained in the medical record.

 

 

Utilization Guidelines

 

• The frequency of measurements of cardiac output monitoring by thoracic electrical bioimpedance which Medicare will consider medically reasonable and necessary will be based on the purpose for which the measurement is obtained.

• The following are examples of categories of use and the general guidelines regarding measurement frequency:

o Diagnostic.

 Frequency of use for diagnostic purposes will apply to patients in whom congestive heart failure is evident, yet its etiology is unclear.

 An initial measurement may be sufficient, with infrequent follow-up assessments.

 Examples include (but are not limited to):

• A patient with respiratory failure and the need to distinguish the presence of a cardiac component of the illness.

• Pericardial effusion of uncertain hemodynamic significance.

• Suspected diastolic dysfunction or the presence of congestive heart failure in the setting of normal left ventricular function.

o Titration of Therapeutic Agents.

 Frequency of use for monitoring therapeutic drug response will require more frequent measurements, and may vary.

 The frequency at which titration of the therapeutic agents is considered medically reasonable and necessary will be based on whether the drug is approved for use in a regimented fashion.

 Examples include (but are not limited to):

• Medication adjustments in patients with refractory congestive heart failure due to either systolic or diastolic dysfunction (especially patients with a left ventricular ejection fraction < 40%).

• Medication adjustments for patients receiving a hemodynamically active anti-hypertensive medication for which a regimented or standardized approach exists.

o Weekly assessments may be considered reasonable in patients undergoing titration of medications for which there is a regimented approach to titration (e.g., carvedilol).

o Because individual tolerance is quite variable and the side effects make it difficult to ascertain whether the patient is realizing maximal benefit, knowledge of the cardiac output as an objective measure would assist the practitioner in decisions regarding titration.

o ACE inhibitors may also fall into this category, yet a maximum of 4 to 6 weekly measurements may be sufficient, with subsequent measurements at 1-3 month intervals

o Monitoring - Frequency of use for monitoring of a patient for a period of clinical assessment should be thought of as a single use.

o Examples include:

 To determine the effect of changes in pacemaker programming where several adjustments might be made during a single visit to optimize pacemaker function.

 Hemodynamic monitoring during a surgical procedure that takes place in the physician's office.

 NOTE: Measurement of cardiac output monitoring by thoracic electrical bioimpedance is not considered medically reasonable and necessary upon each visit or for each change in the patient's medication regimen.

 

 

Sources of Information and Basis for Decision

 

Drazner MH, et al. Comparison of impedance cardiography with invasive hemodynamic measurements in patients with heart failure secondary to ischemia of nonischemic cardiomyopathy. Amer J Cardiol 2002 Apr 15; 18(8):993-5.

 

FCSO L29091, Cardiac Output Monitoring by Thoracic Electrical Bioimpedance, 10/01/2011. The official local coverage determination (LCD) is the version on the Medicare coverage database at www.cms.gov/medicare-coverage-database/.

 

Gilbert J, Lazio L.; Managing congestive heart failure with thoracic electrical bioimpedance.,: AACN Clin Issues 1999 Aug;10(3):400-5

 

Hartleb M, Rudzki K, Waluga M, Janusz M, Karpel E.; Usefulness of thoracic electrical bioimpedance in detection of ejection fraction changes., J Physiol Pharmacol 2000 Mar;51(1):151-9

 

Hirschl MM, Kittler H, Woisetschlager C, Siostrzonek P, Staudinger T, Kofler J, Oschatz E, Bur A, Gwechenberger M, Laggner AN.; Simultaneous comparison of thoracic bioimpedance and arterial pulse waveform-derived cardiac output with thermodilution measurement., Crit Care Med 2000 Jun;28(6):1798-802

 

Imhoff M, et al. Noninvasive whole-body electrical bioimpedance cardiac output and invasive thermodilution cardiac output in high-risk surgical patients. Crit Care Med 2000 Aug; 28(8):2812-8.

 

Jordan HS, Ioannidis JPA, Goudas LC, et al. and the Tufts-New England Medical Center AHRQ Evidence-based Practice Center. Thoracic electrical bioimpedance. EPC Technical Support of the CPTA Technology Assessment Program. Contract No. 290-97-0019, Task Order #10. Rockville, MD: AHRQ; revised November 27, 2002. Available at: http://www.cms.hhs.gov/mcd/viewtechassess.asp?id=23. Accessed October 3, 2003.

 

Kosowsky JM, et al. Assessment of stroke index using impedance cardiography: comparison with traditional vital signs for detection of moderate acute loss of blood in healthy volunteers. Acad Emerg Med 2002 Aug;9(8):775-80.

 

Lasater, R.N., MSN, CCRN, M. (1998). The view within: The emerging technology of thoracic electrical bioimpedance. Critical Care Nursing Quarterly, 21 (3), 97-101.

 

Marrocco, A., Eskin, B., Nashed, A., et al. (1998). Noninvasive bioimpedance monitoring differentiates cardiogenic from pulmonary causes of acute dyspnea in the emergency department. SAEM 1998 Annual Meeting Academic Emergency Medicine, 5 (5), 476-477.

 

Milzman, D., Hogan, C., Zlindenny, A., et al. (1998). The utility of thoracic impedance to evaluate chest radiograph changes from acute heart failure patients in the emergency department. Journal of Cardiac Failure, 4 (3), Supplement 1.

 

Nakonezny PA, et al. New ambulatory impedance cardiograph validated against Minnesota Impedance Cardiograph. Psychophysiol 2001 May; 38:465-73.

 

1999 World Health Organization-International Society of Hypertension guidelines for the management of hypertension. Guidelines Subcommittee. Journal of Hypertension, 17 (2), 151-183.

 

Sageman WS, et al. Equivalence of bioimpedance and thermodilution in measuring cardiac index after cardiac surgery. J Cardiothorac Vas Anesth 2002 Feb; 16(1):8-14.

 

Spiess BD, et al. Comparison of bioimpedance versus thermodilution cardiac output during cardiac surgery; evaluation of a second generation bioimpedance device. J Cardiothorac Vasc Anesth 2001; 15(5):567-73.

 

U.S. Department of Health and Human Services, Center for Medicare and Medicaid Services (CMS). Decision memo for electrical bioimpedance for cardiac output monitoring (CAG-00001R). Medicare Coverage Database. Baltimore, MD: CMS; August 7, 2003. http://www.cms.hhs.gov/mcd/viewdecisionmemo.asp?id=23. Accessed October 3, 2003.

 

Zaluska W, Jaroszynski A, Bober E, Malecka T, Kozik J, Ksiazek A.; [Measurement of fluid compartments using electrical bioimpedance for assessment of target weight in hemodialysis patients], Przegl Lek 2000;57(12):707-10

 

1999 World Health Organization-International Society of Hypertension guidelines for the management of hypertension. Guidelines Subcommittee. Journal of Hypertension, 17 (2), 151-183.

 

 

AMA CPT Copyright Statement

 

CPT codes, descriptions and other data only are copyright 2011 American Medical Association (or such other date of publication of CPT). All Rights Reserved. Applicable FARS/DFARS Clauses Apply.

 

 

LCD Cardiac Output Monitoring By Thoracic Electrical Bioimpedance (L28793)