Measuring and Managing Healthy Living
Bioelectrical Impedance Analysis
Technician
• Statements and Indications For Use
• Brief background of
Body Composition Assessment
• Proper BIA procedure
• Procedural Coding
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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.
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Indications For Use
The following outlines RJL Systems Indications of Use cleared by the FDA.
Calculation and Historical Tracking of:
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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)
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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.
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Why is accurate
Body Composition
Assessment necessary?
• Weight loss is not always healthy.
• We need to know which components are changing: fat,
lean dry mass, intracellular water…?
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Evidence-based
medicine
requires evidence
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We need the
details!
A blood analysis tells us what
is in the blood.
BIA helps tell us
what is in the body weight.
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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…
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How BIA works
• The small electrical current used in BIA
reacts differently in the various compartments
of the body (water, fat, lean mass, etc.)
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BIA Protocol
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BIA Protocol
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Sample Permission Form (modify for your needs)
Recommendations to discuss with your physician
Optimal Preparation
Notations
Standardized BIA Protocol
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Sample Permission Form, 1 of 2 pages
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.)
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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
RJL Bioelectrical Impedance Analysis for Body Composition
First Name
Last Name
Mailing Address
Date of Birth
Middle
Initial
Phone
Gender
M
Email
City, State, Zip
What target
weight would you
like to achieve?
Activity/Exercise/ Fitness
How many sessions per week?
Activity/Exercise/Fitness
How many hours per session?
Check here to join our mailing list!
List types of Activity/Fitness here:
Occupation
F
Age
Females: Date of
Last Menstrual
Period
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,
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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
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Standardized BIA protocol
• Remove sock, stocking, shoe, jewelry, and any objects
from the electrode sites.
• Remove any therapeutic magnets, cellphone or other
electronic devices.
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Standardized BIA protocol
• Supine position on a flat surface – AMA definition
• Knees separated, with arms out 30 degrees from waist, palms down
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Standardized BIA protocol
“RED
WIRE SET
on the
hand
toward
HEAD.”
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Standardized BIA protocol
Clean the 4 electrode sites with alcohol pad, and allow to dry
(about 30 seconds)
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Standardized BIA protocol
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.
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BIA Measurements
• The BIA device will give you
2 measures you need to record:
• Reactance (Xc) energy storage
and
Resistance (R) energy dissipation
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Standardized BIA protocol
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.
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Accurately record pertinent patient data:
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Name and/or Patient I.D. (as directed by your practitioner)
Height
Weight
Age
Gender
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BC 3.0 Software
(MAC or PC) Report Options
• 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.
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Population Equation Set Options
•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)
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Awareness
RJL BIA is supine position, as is defined by the
American Medical Association.
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• CPT Code 0358T
BIA Whole Body Composition,
supine position,
with interpretation and report
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Awareness
Non-supine BIA methods, such as hand-held
or standing BIA methods are not eligible for the
American Medical Association 0358T CPT Code.
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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
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RJL Systems
33939 Harper Avenue
Clinton 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