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The CPT® Code 55920 refers to the procedure involving the placement of needles or catheters into pelvic organs and/or genitalia, specifically excluding the prostate, for the purpose of subsequent interstitial radioelement application. This procedure is a critical step in the treatment of certain malignancies, as it facilitates the delivery of brachytherapy, a form of radiation therapy where radioactive sources are placed directly within or near the tumor. The placement of these needles or catheters is essential for ensuring that the radiation is accurately targeted to the tumor while minimizing exposure to surrounding healthy tissues. The procedure is tailored to the specific anatomical considerations of the patient, taking into account the location of the malignant neoplasm and the differences in male and female anatomy. During the procedure, various tools and techniques are employed, including the use of a radiopaque urinary tract catheter to assist in visualizing the urethral meatus, and the assessment of tumor volume and its relationship to adjacent normal structures. A template device may also be utilized to ensure precise orientation of the brachytherapy needles or catheters, which are then sutured into place. The overall goal of this procedure is to prepare the patient for the subsequent application of radioactive elements, which is reported separately under a different code.
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The procedure coded as CPT® 55920 is indicated for the placement of needles or catheters into pelvic organs and/or genitalia, excluding the prostate, for the purpose of subsequent interstitial radioelement application. This procedure is typically performed in patients diagnosed with malignant neoplasms located in the pelvic region, where targeted radiation therapy is necessary to treat the cancer effectively.
The procedure involves several critical steps to ensure the accurate placement of needles or catheters. Initially, a radiopaque urinary tract catheter may be inserted into the bladder to mark the urethral meatus, which aids in visualizing the anatomy during the procedure. Following this, the tumor volume is assessed, and the relationship of the tumor to adjacent normal structures is carefully evaluated. Based on these assessments, a template device may be selected and prepared to orient the brachytherapy needles or catheters accurately. This template is then sutured into place to maintain its position during the procedure.
After the completion of the needle or catheter placement, post-procedure care is essential to monitor the patient for any complications and to ensure the proper functioning of the inserted devices. Patients may be observed for signs of infection, bleeding, or any adverse reactions related to the procedure. Follow-up imaging may be required to confirm the correct placement of the needles or catheters. Additionally, instructions regarding activity restrictions and care of the insertion sites may be provided to the patient to facilitate recovery and minimize risks. The subsequent application of interstitial radioelements will be scheduled as part of the overall treatment plan, which is reported separately.
| Short Descr | PLACE NEEDLES PELVIC FOR RT | Medium Descr | PLACEMENT NEEDLE PELVIC ORGAN RADIOELEMENT APPL | Long Descr | Placement of needles or catheters into pelvic organs and/or genitalia (except prostate) for subsequent interstitial radioelement application | Status Code | Active Code | Global Days | 000 - Endoscopic or Minor Procedure | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard 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 | Hospital Part B services paid through a comprehensive APC | ASC Payment Indicator | Non office-based surgical procedure added in CY 2008 or later; payment based on OPPS relative payment weight. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P7B - Oncology - other | MUE | 1 | CCS Clinical Classification | 117 - Other non-OR therapeutic procedures, male genital |
| 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | CR | Catastrophe/disaster related | GC | This service has been performed in part by a resident under the direction of a teaching physician | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| 2008-01-01 | Added | First appearance in code book in 2008. |
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