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MP 2.01.11 Total Body and Regional Hypothermia

Medical Policy
Section
Medicine
Original Policy Date
12/1/95
Last Review Status/Date
No routine review scheduled/1:2003
Issue
1:2003
Return to Medical Policy Index

Disclaimer

Our medical policies are designed for informational purposes only and are not an authorization, or an explanation of benefits, or a contract.  Receipt of benefits is subject to satisfaction of all terms and conditions of the coverage.  Medical technology is constantly changing, and we reserve the right to review and update our policies periodically.


Description

Total and regional body hypothermia is the lowering of the total body temperature to less than 30° C in order to limit ischemic damage during surgical procedures. Total body hypothermia is an integral part of certain procedures, such as open heart surgery. Regional body hypothermia, involving catheter infusion of iced saline solution, is used during procedures that involve clamping a critical artery; common examples include renal procedures.


Policy

Total body and regional hypothermia may be considered medically necessary as a technique to limit ischemic damage during surgical procedures.


Policy Guidelines

No applicable information


Benefit Application

BlueCard/National Account Issues

Total and regional body hypothermia (CPT codes 99186 and 99185, respectively) may be considered an integral part of the accompanying surgical procedure and associated anesthesia (i.e., CPT code 99116) and thus may not be eligible for payment as a separate procedure. When billed separately, total body hypothermia is typically billed by the anesthesiologist, while regional hypothermia is billed by the surgeon.


Rationale

2002 Update
 
A literature search of the MEDLINE database was performed for the period of 1998 to 2002. No literature was identified that would change the policy statement. Both regional and total hypothermia continue to be a standard component of certain surgeries. The focus of this policy is not on clinical issues, but rather the Benefit Application section, which remains unchanged.

 

Codes

Number

Description

CPT  99116  Anesthesia complicated by utilization of total body hypothermia 
  99185  Hypothermia; regional 
  99186  Hypothermia; total body 
ICD-9 Procedure  39.62  Hypothermia (systemic) incidental to open heart surgery 
HCPCS  No code 
Type of Service  Medical 
Place of Service  Inpatient 


Index

Hypothermia, Total Body
Total Body Hypothermia


Policy History

Date Action Reason
12/01/95 Add to Medicine section New Policy
04/01/98 Replace Policy Updated to include regional hypothermia
12/18/02 Replace Policy Policy reviewed; policy statement and benefit applications section unchanged
04/29/03 Replace Policy Policy no longer scheduled for routine literature review.


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