Measuring and Managing Healthy Living Bioelectrical Impedance Analysis Technician

Measuring and Managing Healthy Living Bioelectrical Impedance Analysis

Technician

Measuring and Managing Healthy Living

• Statements and Indications For Use

• Brief background of Body Composition Assessment

• Proper BIA procedure

• Procedural Coding


PLEASE NOTE

The content of this slide deck is for informational purposes only.

BIA technology is not intended to prevent, cure, diagnose, or treat any particular disease state.

BIA technology does not replace the educated judgment of a licensed health care professional.


Indications For Use The following outlines RJL Systems Indications of Use cleared by the FDA. Calculation and Historical Tracking of: ■ Actual Impedance■ Actual Phase Angle (PA)■ Actual Body Mass Index (BMI)■ Estimated Body Fat (FAT)■ Estimated Fat Free Mass (FFM)■ Lean Dry Mass (LDM)■ Estimated Total Body Water (TBW)■ Estimated Intra-Cellular Water (ICW)■ Estimated Extra-Cellular Water (ECW)■ Estimated Basal Metabolic Rate (BMR)■ Estimated Daily Energy Expenditure (DEE)


Indications For Use Intended Population:BC is intended only for use on normally healthy adults and adolescents age 3-94. The prediction equations used by the BC software assume that the person being tested has not had either arm or leg amputated. It is not intended to be used to diagnose, treat, or cure any disease or medical condition. Contraindications:No known contraindications exist. Warnings:The BC software provides body composition estimates based on the electrical characteristics measured by a Bioelectrical Impedance Analyzer (BIA). BIA works by introducing an alternating current (AC) signal into the body and then measuring how that signal is affected by the body. This device should not be used on subjects with any implanted electronic devices such as pacemakers or implantable cardioverter-defibrillators (ICD)’s.


Why is accurateBody Composition

Assessment necessary?

• Weight loss is not always healthy.

• We need to know which components are changing: fat, lean dry mass, intracellular water…?


Evidence-based medicine

requires evidence


A blood analysis tells us what is in the blood.

BIA helps tell uswhat is in the body weight.

We need the details!

Photo Courtesy of COM SALUD


RJL BIA is used all over the world•Integrated and Functional Medicine

•Preventive and Lifestyle Medicine

•Hospitals and Private Practice

•University and Military Research

•NASA, NOAA

•NIH

•CTCA

•Mayo Clinic, Cleveland Clinic, Harvard, Yale…



How BIA works• The small electrical current used in BIA

reacts differently in the various compartments of the body (water, fat, lean mass, etc.)


BIA Protocol


BIA Protocol

• Sample Permission Form (modify for your needs)• Recommendations to discuss with your physician• Optimal Preparation• Notations• Standardized BIA Protocol

RJL Bioelectrical Impedance Analysis for Body Composition My signature below indicates that I agree to the following: (Check off each box before signing this form. Ask questions on any item you do not understand.)

I understand that this Body Composition Analysis will give me numerous biomarker values. I understand that I will receive a report to share and discuss with my physician or

health care provider. I am NOT pregnant. I do not have a pacemaker, defibrillator, medication pump, or other implanted

medical electronic device. I have notified the Technician if I have had a metal joint replacement or metal

rod/pin implants of any kind. I have been given contact information if I have any questions at a later date. I release the Technician from any liability of any kind. I have emptied my bladder and/or bowels prior to the test. My cellphone will not be near my body during the Assessment. I have removed any metal jewelry, magnetic objects and therapeutic magnets. I have removed the shoe, sock, or stocking from my right foot and ankle

(OR left side, if directed by Technician).

______________________________________________ __________________ Signature Date

Sample Permission Form, 1 of 2 pages

Sample Permission Form, 1 of 2 pages

RJL Bioelectrical Impedance Analysis for Body Composition First Name

Last Name

Middle Initial

Mailing Address

Date of Birth Phone Gender M F

City, State, Zip

Email Check here to join our mailing list!

Age

What target weight would you like to achieve?

Activity/Exercise/ Fitness How many sessions per week?

List types of Activity/Fitness here: Occupation Females: Date of Last Menstrual Period

Activity/Exercise/Fitness How many hours per session?


Recommendations to Discuss with your Physician

•Joint Replacements: OK to use Average Range comparisons. Do the procedure on the opposite side of the body, and make a notation.

•Limb Replacements: NOT OK to use Average Range comparisons. Do the procedure on the opposite side of body, and make a notation. Only make qualitative comparisons over multiple visits.

•Pregnancy: NOT recommended

•Medical Device Implants: NOT recommended (i.e. pacemaker, defib, medical pump,etc.)


Optimal BIA Protocol Preparation

•No alcohol 24 hours prior

•No caffeine 4 hours prior

•No exercise 4 hours prior

•Notate sauna or Bikram Yoga, etc. if within 24 hours

•Drink 2 glasses of water 2 hours prior

•Empty bladder and/or bowel prior to analysis

If your patient varied from

this Preparation, make a

note on the Report for your

practitioner


Standardized BIA protocol

•Remove sock, stocking, shoe, jewelry, and any objects from the electrode sites.

•Remove any therapeutic magnets, cellphone or other electronic devices.


•Supine position on a flat surface – AMA definition

•Knees separated, with arms out 30 degrees from waist, palms down




“REDWIRE SET

on the hand

toward HEAD.”


Clean the 4 electrode sites with alcohol pad, and allow to dry (about 30 seconds)



The patient should have been lying supine position about 3-5 minutes(while you clean the electrode sites, apply the adhesive pads, and properly attach the device clips), to allow the fluids of the body to stabilize.



• The BIA device will give you 2 measures you need to record:

• Reactance (Xc) energy storage and Resistance (R) energy dissipation

BIA Measurements


Once the Resistance and Reactance data is accurately recorded, the procedure is complete.

You may now remove and discard the adhesive electrodes. Electrodes are NOT reusable.



Accurately record pertinent patient data:

• Name and/or Patient I.D. (as directed by your practitioner)• Height • Weight• Age• Gender


• Target Weight (software fills this in, but your practitioner may decide to override)

• Notations (limb replacement, or recent exercise, sauna, alcohol, surgery, etc.)

• Lab biomarkers: measurements, HgBA1C, Lipids, BP, etc.

• Reports can be stored or emailed as a pdf, and printed.

• You choose tables, graphs, and whether you want to print the Food & Fitness section or Average Ranges.

BC 3.0 Software (MAC or PC) Report Options


Population Equation Set Options

•NHANES-III (General Population)NHANES-III (General Population) Most utilized, appropriate for a ‘typical’ person. If you have a “thin/fit/skinny” individual, your practitioner may consider the Athletic or Obese equation sets, as appropriate.•New Pediatric (Ages 4 – 19; also validated for obese children) •Mexican Adults (Male & Female ) •Native Americans •Obese (BMI > 30 ) •Obese African American•Athletic •HIV •All Body Types (BMI adjustable)


Awareness

RJL BIA is supine position, as is defined by the American Medical Association.


• CPT Code 0358TBIA Whole Body Composition,

supine position, with interpretation and report


Awareness

Non-supine BIA methods, such as hand-held or standing BIA methods are not eligible for the American Medical Association 0358T CPT Code.


Awareness

Non-supine BIA methods may have compromised accuracy due to:

-unstable central venous pressure -callouses on hands & feet -temperature and moisture variations on the palms of the hands -temperature and moisture variations on the bottoms of the feet

RJL Systems33939 Harper AvenueClinton Township, MI 48035(800) 528-4513 www.RJLSystems.com

Photo Credits: Sunrise – Santa Banta, Midday – Dreamstime.com, Sunset –David baker, Icons (page 9) –unrestrictedstock.com

Documents

Measuring and Managing Healthy Living Bioelectrical Impedance Analysis Technician