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What You Should Know

Both physicians and patients can feel confident that every precaution has been taken to ensure a successful outcome and avoid unintentional surgically-induced injuries. IONM (Intraoperative Neurophysiological Monitoring) applies SSEP (somatosensory evoked potentials ), BAEP (brainstem auditory evoked potentials), tceMEP (transcranial electric motor evoked potentials), EMG (Electromyography), and EEG (Electroencephalography) recording techniques to detect any changes in the functional status of critical neurological structures that are at risk during surgery.

United Medical Monitoring provides surgeons with an early warning system regarding iatrogenic injuries (surgically induced injuries), thus allowing the surgeon to avoid potential problems. IONM can be helpful in clarifying anatomical structures that have been distorted by degenerative disease, congenital anomalies, revision surgery, tumor, or inflammatory processes that may obscure normal anatomic relationships and surgical landmarks.

It can help identify new systematic (nervous system) impairment and identify or separate nervous system structures (for instance, around or in a tumor or scar tissue), and can demonstrate which tracts or nerves are still functional. When a surgeon has the benefit of early warning of altered neurological functions they can intervene immediately and avoid or reverse the potential for injury.

Any surgical procedure has a risk for complications, which can lead to an Iatrogenic injury– an injury during surgery. The accepted incidence of neurological deficit is 11-15% for procedures in, and around, structures of the nervous system. IONM can help surgeons reduce risk by more than 50% and can provide early detection of neurologic injuries, which affords the surgical team an opportunity to perform rapid intervention to prevent injury progression or reverse impending neurologic damage.

United Medical Monitoring has a team of very experienced CNIM (Certification for Neurophysiological Intraoperative Monitoring) technicians that can easily handle any surgical case that requires monitoring. In addition, United employs highly specialized DABNM (Diplomat, American Board of Neurophysiological Monitoring) technicians, for very complex surgeries.

United’s monitoring program is a collective effort between the CNIM technicians, the remote monitoring physicians and the surgeons. All interpreting physicians and CNIM technicians are evaluated on a monthly basis. Quarterly and semi-annual QA reports are provided to hospitals and surgical practices. These reports function as a compliance tool. The QA reports include individual and group scoring relative to established criteria guidelines. The metrics United Medical Monitoring uses are designed to promote collaboration between the interpreting physician, the technician and the surgeon, and help United refine and customize the IONM services to improve patient outcomes.

United has an world-class group intraoperative neurophysiological monitoring physicians, with Board certification’s in all specialties necessary to cover the full-spectrum of intraoperative neuromonitoring needs. This would include the following Board Certifications: (1) The American Board of Neurophysiological Monitoring (ABNM); (2) the American Board of Psychiatry and Neurology (ABPN); (3) the American Board of Clinical Neurophysiology (ABCN); (4) the American Board of Electrodiagnostic Medicine (ABEM); (5) Doctor of Medicine with specialized training in IONM; or (6) Doctor of Audiology with specialized training in IONM.

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What To Expect

United Medical Monitoring CNIM technicians and physicians will collect, analyze, and interpret data from your body’s nervous system during your scheduled surgery. Prior to the start of the surgical procedure, small electrodes will be attached (with a mild adhesive or inserted just under the skin) to various parts of the patient’s body. United’s technologists and physicians will use these electrodes and computers to continuously monitor the functional status of at risk neural pathways and help identify the potential for injuries to the central and peripheral nervous system.

How Is IONM Useful

IONM can detect mechanical stretching of the spinal cord, brainstem, cranial, and peripheral nerves, as well as the disruption of cerebral, brainstem, cranial, and spinal cord blood flow. It can also be helpful in clarifying anatomical structures that have been distorted by degenerative disease, congenital anomalies, revision surgery, tumor, or inflammatory processes that may obscure normal anatomic relationships and surgical landmarks.

IONM can also help identify new systematic impairments, identify nervous system structures (e.g. in and around a tumor or scar tissue), and demonstrate which nerves are still functioning. This gives surgeons an early warning system for altered neurological functions so they can intervene immediately to avoid or reverse the potential for injury.

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Participating Physcians

United Medical Monitoring technicians are supported by physicians who provide remote real-time monitoring services over an online connection to people across the entire United States. All services rendered are provided under a contractual arrangement between United and the facility and/or the surgeon. It is the responsibility of the surgeon to let the patient know if they are requesting IONM for the surgery.

Network Participation

Our physicians service institutions across the United States and negotiating network contracts with all the different insurer networks accepted at each of these facilities in each state is not always possible. Please check with your insurer for specific information regarding coverage for IONM services.

Billing Process

When the surgery is complete a bill will be generated and sent to the insurer on behalf of the patient for payment of the monitoring services. Once the insurance company notifies United Medical Monitoring or one of its affiliated physicians about patient co-pay or deductibles, the patient will be contacted and will receive a statement for the balance, if any is due.

Billing Policies

All claims for IONM services are reported in accordance to AMA/CPT guidelines and practice billing policies, a copy of which is available upon request.