CPT® Code 57156

The CPT® Code 57156 refers to the insertion of a vaginal radiation afterloading apparatus specifically for clinical brachytherapy. This procedure is a form of internal radiation therapy that is commonly utilized in the treatment of uterine cancer, particularly after a hysterectomy has been performed. The primary goal of vaginal brachytherapy is to deliver targeted radiation to the upper vaginal region, which is at a heightened risk for cancer recurrence. The procedure involves the use of a specialized cylinder apparatus that is inserted into the vagina, allowing for precise placement of the radiation source. Prior to the procedure, the bowel is prepared using a Fleet enema to ensure optimal conditions for treatment. During the procedure, the patient is positioned supine with feet in stirrups, and the perineal and genital areas are thoroughly cleansed to maintain sterility. Catheters are then placed in the bladder and rectum to facilitate imaging and ensure proper positioning of the radiation apparatus. The physician carefully inserts the vaginal cylinder and secures it in place, followed by the injection of contrast material into the bladder and rectal catheters. This imaging step is crucial for evaluating the cylinder's position relative to surrounding organs, which aids in the development of a tailored treatment plan. The physician subsequently delivers the prescribed radiation dose through the channels of the cylinder, ensuring that the treatment is focused on the areas at risk while minimizing exposure to adjacent healthy tissues. After the completion of the brachytherapy, the vaginal cylinder, along with the bladder and rectal catheters, is removed, concluding the procedure.