CPT® Code 19297

Add-On Code

Placement of radiotherapy afterloading expandable catheter (single or multichannel) into the breast for interstitial radioelement application following partial mastectomy, includes imaging guidance; concurrent with partial mastectomy (List separately in addition to code for primary procedure)

The CPT® Code 19297 refers to the placement of a radiotherapy afterloading expandable catheter, which can be either single or multichannel, into the breast for the purpose of interstitial radioelement application following a partial mastectomy. This procedure is performed in conjunction with imaging guidance and is specifically noted to be listed separately in addition to the code for the primary procedure. The primary aim of this intervention is to deliver targeted radiation therapy directly into the surgical cavity created by the partial mastectomy, lumpectomy, or excisional biopsy. Unlike traditional radiation therapy that irradiates the entire breast, this method focuses on the surgical site and a small surrounding margin, allowing for a more localized treatment approach. This technique not only enhances the precision of radiation delivery but also significantly reduces the overall treatment duration, completing the therapy in a matter of days rather than weeks. The procedure involves making a single incision, through which a trocar is inserted into the surgical cavity under ultrasound guidance to facilitate the placement of the expandable catheter. Once the trocar is removed, the applicator is introduced into the cavity in a closed position, and an expansion tool is utilized to deploy the catheter, which typically consists of multiple lumens surrounding a central lumen. This design allows the catheter to expand and conform to the cavity's size, ensuring optimal placement for effective radiation delivery. The catheter is then connected to an after-loading device that administers the radiation source, providing a flexible and controlled treatment option that combines the advantages of tissue-sparing interstitial brachytherapy with the convenience of intracavitary balloon brachytherapy. This procedure can be performed either on the same day as the lumpectomy or partial mastectomy or on a subsequent date, depending on the clinical scenario.