Surgical Monitoring Services

FREQUENTLY ASKED QUESTIONS

Question:	*What does NIOM stand for?*
Answer:	NIOM stands for Neurological Intraoperative Monitoring. A highly trained, board certified technologist, called a Clinical Specialist in NIOM, delivers this type of health care in the operating room, at the request of the operating surgeon. Surgical Monitoring Services employs and utilizes only qualified board certified/board eligible personnel.

Question:	What is NIOM?
Answer:	Neurological Intraoperative Monitoring (NIOM) is an interventional tool, used during head, neck, vascular, joint and spinal surgery. The primary purpose is to help reduce the risk of injury to nerve structures directly related to the type and location of the surgical procedure. NIOM allows for the detection of possible damage to the central and peripheral nervous system, and alerts the operating surgeon so that he or she can act to help prevent a permanent neurological problem. The NIOM team works closely with the surgeon, the anesthesia team, and the operating room nurses.

Question:	How does NIOM work?
Answer:	The NIOM Clinical Specialist will interview the patient prior to the surgical procedure. He or she will obtained a detailed medical history, including all medications being taken by the patient, previous surgical procedures, chronic health conditions, history of trauma, current pain sites and pain level. The Clinical Specialist will fully explain the NIOM procedure, and answer all questions and concerns the patient may have. Electrodes will then be applied to the patient's wrists and ankles, over peripheral nerves that lie close to the skin's surface. These nerves will be electrically stimulated and used to send a signal to the brain. Additionally, specific muscle groups related to particular nerve structures will also be monitored, as determined necessary by the surgeon and the monitoring team. During surgery, NIOM will be utilized to continuously monitor the nervous system by monitoring the electrical impulses as they pass from the peripheral nerves in the wrists and ankles, through the spinal cord to the brain. NIOM helps reduce risk of damage to the nervous system by allowing the NIOM team to alert the surgeon if and when spinal cord or neural structure compromise appears imminent. Armed with information from the NIOM team about changes in the conduction of electrical impulses, the surgical team can take corrective action before neurological injury becomes permanent.

Question:	Does NIOM hurt?
Answer:	No. Topical electrode placement is painless, and the majority of electrodes are applied after the patient is anesthetized.

Question:	Is there a recovery time from NIOM?
Answer:	There is no recovery time for patients when NIOM is utilized. All electrodes are removed before the patient leaves the operating room suite.

Question:	Does NIOM monitoring cause any injury?
Answer:	NIOM monitoring is a safe and effective procedure. The NIOM Clinical Specialist is a highly trained, board certified professional, who works within stated industry guidelines for Electrical Safety and Universal Precautions.

Question:	How are Surgical Monitoring Services Clinical Specialists trained?
Answer:	All Clinical Specialists must possess, as a minimum, an undergraduate degree in a Bioscience, and a board registration of competency from ABRET (The American Board of Electroneurodiagnostic Technologists). Training for board registration includes; Anatomy/Physiology, Neuroanatomy, Pharmacology, Disease Process, NIOM Technology, Computer Programming , Electrical Safety, and Universal Precautions.

Question:	Is there a charge for NIOM services?
Answer:	Surgical Monitoring Services directly bills the patient's insurance carrier for technical service fees, for which there may be a charge to the patient after insurance benefits have been assigned.

Question:	Will my insurance cover the NIOM procedure?
Answer:	Coverage depends upon your insurance plan. SMS employs a specialized medical billing team that exhausts all appeals processes to ensure that each claim is paid at the highest benefit level.