CPT® Code 0619T

Cystourethroscopy with transurethral anterior prostate commissurotomy and drug delivery, including transrectal ultrasound and fluoroscopy, when performed

Cystourethroscopy with transurethral anterior prostate commissurotomy and drug delivery, as described by CPT® Code 0619T, is a specialized minimally invasive procedure aimed at alleviating urinary symptoms associated with benign prostatic hypertrophy (BPH). This technique involves the use of a cystoscope, a flexible instrument that combines both visual and surgical capabilities, which is inserted through the urethra to access the bladder. During the procedure, the area where the prostate encircles the urethra is carefully visualized. The procedure may utilize electrical current or laser energy to create one or two small grooves in the tissue connecting the prostate to the bladder, effectively dividing the anterior prostatic commissure and the bladder neck while preserving the surrounding mucosal tissue. This cutting action helps to relax the musculature of the bladder opening, thereby decompressing the urethra and reducing resistance, which facilitates easier passage of urine. Following the commissurotomy, a drug is delivered through the catheter to help maintain the patency of the urinary channel. The Optilume™ BPH catheter system represents an innovative approach to this procedure, allowing for effective results similar to traditional prostate resection techniques without the need for cutting, burning, vaporizing, or lasering. Instead, a predilation balloon catheter is utilized to exert radial force, dilating the prostatic urethra and achieving the commissurotomy to relieve obstruction. A drug-coated balloon catheter, featuring a proprietary coating of paclitaxel, is then introduced; upon inflation, this balloon transfers the drug to the lining of the urethra, promoting sustained opening of the newly divided tissue.