What is the purpose of the ICG Simulator – why should I purchase one?
Is there Physician Reimbursement for use of LIFEGARD ICG?
What are the Lifegard ICG Derived Parameters
INDENStroke Volume / Stroke Index (SV / SI): [30-120] / [30-65] ml / ml/m2
INDENCardiac Output / Cardiac Index (CO / CI): [3.0 – 10.0] / [2.8 – 4.2] l/min / l/min/m2
INDENSystemic Vascular Resistance / SVR Index (SVR / SVRI): [770 – 1560] / [1340- 2480]
INDENdyn * s/cm5 / dyn * s * m2/cm5
INDENVelocity Index (VI) and Acceleration Index (ACI): [33 – 75] 1/1000s / [60 – 150] 1/100 s2
INDENThoracic Fluid Content (TFC): [21 – 50] 1/kOhm
INDENPre-Ejection Period (PEP): [40 – 100] ms
INDENLeft Ventricular Ejection Time (LVET): [200 – 350] ms
INDENSystolic Time Ratio (STR): [15 – 45] %
INDENLeft Cardiac Work Index (LCWI): [3.3 – 5.3] kg m/m2
What is the purpose of the ICG Simulator – why should I purchase one?
The Analogic AN4700-AC001 ICG simulator is the perfect diagnostic tool for the facility’s lab, right alongside the more familiar BP, ECG, and temperature simulators. Although it is not to be used for calibration (the ICG function of the monitor does not require calibration), the technician can determine quickly if a problem is in the monitor or cables, or is an operator error.
Is there Physician Reimbursement for use of LIFEGARD ICG?
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
42 CFR Parts 410, 414
Payment Policies Under the Physician Fee Schedule for Calendar Year 2005
Effective Date: This rule is effective on January 1, 2005
Description: Bioimpedance, thoracic, electrical
Frequency Allowable: Once per physician, per patient, per day, as medically necessary.
|
CPT Code: |
93701 (Global) |
|
|
93701-TC (Technical) |
|
|
93701-26 (Professional) |
|
Relative Value Units (RVU): |
Practice Expense |
0.98 |
|
|
Malpractice |
0.02 |
|
|
Physician Work |
0.17 |
|
|
Total |
1.17 |
Back to top of page
Lifegard ICG Derived Parameters:
The Lifegard ICG Monitor offers noninvasive, continuous, beat-by-beat measurements of:
- Stroke Volume (SV) [30-120] ml
- Stroke Index (SI) [30-65] ml/m2
- Cardiac Output (CO) [3.0 – 10.0] l/min
- Cardiac Index (CI) [2.8 – 4.2] l/min/m2
- Systemic Vascular Resistance (SVR) dyn * s/cm5 [770 – 1560]
- SVR Index (SVRI) dyn * s * m2/cm5 [1340- 2480]
- Acceleration Index (ACI) [60 – 150] 1/100 s2
- Velocity Index (VI) [33 – 75] 1/1000s
- Pre-Ejection Period (PEP) [40 – 100] ms
- Left Ventricular Ejection Time (LVET) [200 – 350] ms
- Systolic Time Ratio (STR) [15 – 45] %
- Thoracic Fluid Content (TFC) [21 – 50] 1/kOhm
- Left Cardiac Work Index (LCWI) [3.3 – 5.3] kg m/m2
Stroke Volume / Stroke Index (SV / SI): [30-120] / [30-65] ml / ml/m2
SV is the amount of blood the left ventricle ejects in one beat, measured in milliliters per beat (ml/beat). SV can be indexed to a patient's body size by dividing by Body Surface Area (BSA) to yield Stroke Index (SI).
SI = SV/BSA
Cardiac Output / Cardiac Index (CO / CI): [3.0 – 10.0] / [2.8 – 4.2] l/min / l/min/m2
CO is the amount of blood the left ventricle ejects into the systemic circulation in one minute, measured in liters per minute (l/min). CO is Stroke Volume (SV) multiplied by Heart Rate (HR). CO can be indexed to a patient's body size by dividing by Body Surface Area (BSA) to yield Cardiac Index (CI).
CO = SV x HR
CI= CO/BSA
Systemic Vascular Resistance / SVR Index (SVR / SVRI): [770 – 1560] / [1340- 2480] dyn * s/cm5 / dyn * s * m2/cm5
SVR is representative of the force that the left heart must pump against in order to deliver the stroke volume into the periphery. SVR is directly proportional to blood pressure and is indirectly proportional to blood flow (CO). SVR is a measure of afterload.
SVR is determined by the following equation:
SVR = [(MAP - CVP) / CO] x 80
SVR can be indexed to a patient's body size by substituting Cardiac Index for Cardiac Output to yield Systemic Vascular Resistance Index (SVRI).
SVRI = [(MAP - CVP) / CI] x 80
Velocity Index (VI) and Acceleration Index (ACI): [33 – 75] 1/1000s / [60 – 150] 1/100 s2
VI is the maximum rate of impedance change, and is representative of aortic blood velocity. ACI is an index of the peak acceleration of aortic blood flow. ACI= dZ2/dt2MAX /TFI and is representative of aortic blood acceleration. Together the indices are believed to reflect cardiac contractility, or the pumping force of the heart.
Thoracic Fluid Content (TFC): [21 – 50] 1/kOhm
TFC is representative of total fluid volume in the chest, comprised of both intra-vascular and extra-vascular fluid. TFC is calculated as the inverse of the baseline impedance measurement. Baseline impedance is directly proportional to the amount of conductive material (i.e., blood, lung water) in the chest.
Pre-Ejection Period (PEP): [40 – 100] ms
PRE-EJECTION PERIOD (PEP) [msec] is the interval between R wave peak and B point of the ICG. It is the period of isovolumic ventricular contraction.
Left Ventricular Ejection Time (LVET): [200 – 350] ms
The B point marks the opening and the X point the closing of the aortic valve. The LVET is the duration of the mechanical systole.
Systolic Time Ratio (STR): [15 – 45] %
SYSTOLIC Time ratio (STR): Calculated by the systolic time intervals (STI) of pre-ejection period (PEP) and left ventricular ejection time (LVET). [STR= 100% PEP/LVET].
STR = 100% x PEP / LVET
Left Cardiac Work Index (LCWI): [3.3 – 5.3] kg m/m2
LCWI parallels myocardial oxygen consumption, and is the product of blood pressure and blood flow. LCWI is determined with the following equation:
LCWI = (MAP - PAOP) x CO x 0.0144 / BSA
PAOP is Pulmonary Artery Occluded Pressure, or wedge pressure. Outside of direct measurement with a Pulmonary Artery Catheter, a default value of 7 mm Hg can be used because of PAOP's minimal effect on LCW determination.Tel:800-599-7769 (U.S.) or 978-326-4700 (MA & International)
Fax: 978-977-6854
email: lifegard@analogic.com
TERMS OF USE
© 2003 Analogic Corporation. All rights reserved