Drug Induced Sleep Endoscopy (DISE)

"Como codificar drug induced sleep endoscopy (DISE) no contexto de avaliação de roncopatia, SAOS, em que é efetuada perfusão de propofol?"


(Responde Fernando Lopes)
 
Sleep endoscopy, also known as sleep nasoendoscopy (SNE) or drug-induced sleep endoscopy (DISE), is a powerful tool for studying the dynamic airway in a sleeping patient with obstructive sleep apnea (OSA). Using the knowledge gained from sleep endoscopy, the surgeon can tailor the operative procedure to the patient's specific condition.
Due to the difficulty in establishing the site of obstruction in the conscious patient who carries a diagnosis of OSA, the diagnosis and treatment of OSA is a complex and multidimensional issue. Croft and Pringle first proposed sleep endoscopy in 1991. Using midazolam as a sedating agent, they demonstrated the utility of passing a fiberoptic endoscope (see the image below) through a sleeping patient’s nasal cavity to assess pharyngeal structures for evidence of obstruction. They were able to induce the preexisting snoring in 95% of their patients. (emedicne: Sleep Endoscopy)
 
É uma inspeção da faringe sob o efeito de sedação.
Como a sedação não é 'integrante' das endoscopias deve ser codificada.
 
0CJY8ZZ  Inspection of Mouth and Throat, Via Natural or Artificial Opening Endoscopic
3E033NZ  Introduction of Analgesics, Hypnotics, Sedatives into Peripheral Vein, Percutaneous Approach
 
É evidente que não traduz o exame "DISE".
É apenas mais um dos muitos exames que a ICD-10-PCS não contempla especificamente.
 
 
Fernando Lopes