CPT® Code 0564T

Code Deleted. See 89240.

Official Description

Oncology, chemotherapeutic drug cytotoxicity assay of cancer stem cells (CSCs), from cultured CSCs and primary tumor cells, categorical drug response reported based on percent of cytotoxicity observed, a minimum of 14 drugs or drug combinations

Common Language Description

The CPT® Code 0564T refers to an oncology procedure known as a chemotherapeutic drug cytotoxicity assay specifically designed to evaluate the response of cancer stem cells (CSCs) and primary tumor cells to various chemotherapy agents. This assay is crucial in determining how effective specific chemotherapeutic drugs or combinations thereof are in inducing cell death, which is quantified as cytotoxicity. Cytotoxicity, in this context, is defined as the degree of cell death that occurs when tumor cells and CSCs are exposed to chemotherapy treatments. The assay utilizes unfixed tumor tissue, which is cultured to isolate and enrich the cancer stem cells. The cultured tumor cells and CSCs are then placed into separate 96-well plates, where they are treated with a minimum of 14 different chemotherapy drugs or combinations of these drugs. Over a period of 48 hours, the metabolic activity of the treated cells is monitored using a colorimetric assay, which compares the treated cells to a control group of untreated cells. The results of the cytotoxicity assay are expressed as a percentage, indicating the proportion of cells that have died as a result of the drug treatment. A response to treatment is characterized by a cytotoxicity level ranging from 60% to 100%, while a lack of response is indicated by cytotoxicity levels below 10% to 30%.

1. Indications

The chemotherapeutic drug cytotoxicity assay is indicated for use in patients undergoing treatment for cancer, specifically to assess the effectiveness of chemotherapy agents on cancer stem cells and primary tumor cells. This assay is particularly relevant in the following scenarios:

Assessment of Chemotherapy Response The assay is performed to evaluate how well a patient’s cancer cells respond to specific chemotherapy drugs or combinations, aiding in the selection of the most effective treatment regimen.
Personalized Treatment Planning By determining the cytotoxicity levels of various drugs, healthcare providers can tailor chemotherapy plans to individual patients, potentially improving treatment outcomes.
Monitoring Treatment Efficacy The assay can be used to monitor the effectiveness of ongoing chemotherapy treatments, allowing for adjustments based on the observed cytotoxicity levels.

2. Procedure

The procedure for conducting the chemotherapeutic drug cytotoxicity assay involves several key steps that ensure accurate assessment of drug response in cancer cells.

Step 1: Sample Collection Unfixed tumor tissue is collected from the patient, which serves as the source for culturing tumor cells and enriching cancer stem cells. This step is critical as the viability of the cells is essential for accurate assay results.
Step 2: Cell Culture The collected tumor tissue is then cultured in a laboratory setting. This process involves isolating the tumor cells and enriching the cancer stem cells to create a suitable environment for testing the effects of chemotherapy agents.
Step 3: Drug Treatment The cultured tumor cells and enriched CSCs are placed into separate 96-well plates. Each well is treated with a minimum of 14 different chemotherapy drugs or combinations thereof. This step is designed to evaluate a broad spectrum of potential treatment options.
Step 4: Monitoring Metabolic Activity After the drug treatment, the metabolic activity of the cells is monitored over a 48-hour period. This is accomplished using a colorimetric assay, which measures the viability of the cells in comparison to untreated control cells.
Step 5: Data Analysis The results of the assay are analyzed to determine the percentage of cytotoxicity observed. This percentage indicates the level of cell death caused by the drug treatment, providing critical information on the effectiveness of the chemotherapy agents tested.

3. Post-Procedure

Following the completion of the chemotherapeutic drug cytotoxicity assay, the results are compiled and reported to the healthcare provider. The report includes the percentage of cytotoxicity observed for each drug or drug combination tested. Based on these results, the healthcare provider can make informed decisions regarding the patient's chemotherapy regimen. It is important to note that the assay results may guide further treatment planning, including potential adjustments to the current therapy or the exploration of alternative options. Continuous monitoring and follow-up may be necessary to assess the ongoing effectiveness of the chosen treatment strategy.

Short Descr	ONC CHEMO RX CYTOTOX CSC 14
Medium Descr	ONC CHEMO RX CYTOTOXICITY ASSAY CSC MIN 14 DRUGS
Long Descr	Oncology, chemotherapeutic drug cytotoxicity assay of cancer stem cells (CSCs), from cultured CSCs and primary tumor cells, categorical drug response reported based on percent of cytotoxicity observed, a minimum of 14 drugs or drug combinations
Status Code	Carriers Price the Code
Global Days	YYY - Carrier Determines Whether Global Concept Applies
PC/TC Indicator (26, TC)	0 - Physician Service Code
Multiple Procedures (51)	0 - No payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50)	0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions	09 - Concept does not apply.
Assistant Surgeon (80, 82)	0 - Payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62)	0 - Co-surgeons not permitted for this procedure.
Team Surgery (66)	0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family	99 - Concept Does Not Apply
APC Status Indicator	STV-Packaged Codes
Berenson-Eggers TOS (BETOS)	none
MUE	Not applicable/unspecified.