CPT® Code 0735T

Add-On Code

Preparation of tumor cavity, with placement of a radiation therapy applicator for intraoperative radiation therapy (IORT) concurrent with primary craniotomy (List separately in addition to code for primary procedure)

The CPT® Code 0735T refers to the preparation of a tumor cavity, which involves the placement of a radiation therapy applicator specifically for intraoperative radiation therapy (IORT) that is performed concurrently with a primary craniotomy. This procedure is crucial in the management of malignant brain tumors, as it allows for the direct application of high-dose radiation to the area surrounding the tumor cavity immediately after the tumor has been surgically removed. The primary goal of this treatment is to target any residual tumor cells that may remain in the margins of the resected tissue, thereby reducing the risk of tumor recurrence. Intraoperative radiation therapy is a sophisticated technique that requires meticulous planning and execution. Prior to the application of radiation, the surgical team carefully measures and maps the treatment area, ensuring that critical structures such as the brain stem and optic nerve are adequately protected. This involves the use of advanced imaging modalities, including ultrasound, computed tomography (CT), or magnetic resonance imaging (MRI), to visualize the surrounding anatomy and confirm the precise placement of the radiation applicator. The procedure is performed under sterile conditions, with the radiation applicator being draped and positioned within the tumor cavity. Once in place, radiation is delivered for a predetermined duration and intensity, tailored to the specific needs of the patient and the characteristics of the tumor. After the radiation treatment is completed, the applicator and any sterile draping are removed, and the surgical site is closed with careful attention to potential complications such as cerebrospinal fluid leakage or bleeding. It is important to note that IORT is considered a high-risk procedure, with potential complications that may include infection, delayed healing requiring further surgical intervention, cerebral bleeding or ischemia, radiotoxicity, and symptomatic brain necrosis. These risks necessitate thorough preoperative planning and postoperative monitoring to ensure patient safety and optimal outcomes.