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Hyperthermia, externally generated, is a medical procedure designed to elevate the temperature of targeted areas within the body, specifically focusing on superficial or subcutaneous tumor cells while minimizing damage to surrounding healthy tissue. This technique is particularly effective for treating various types of tumors, including both primary and metastatic forms, such as recurring melanoma, recurrent breast cancer located in the chest wall, and cervical lymph node metastases resulting from head or neck cancers. The underlying principle of this procedure is based on the fact that tumor cells exhibit a higher sensitivity to increased temperatures compared to normal cells. By raising the temperature of these malignant cells, hyperthermia can enhance the therapeutic effects of concurrent treatments like radiation and chemotherapy. Additionally, the procedure may stimulate certain components of the immune system, which play a crucial role in targeting and destroying abnormal cells. The heat required for this treatment is generated through methods such as microwave, radiofrequency, or ultrasound, and is applied to a precisely defined area using specialized applicators. Typically, hyperthermia therapy is administered 1 to 2 times per week, culminating in a total of 10 to 12 treatment sessions. Following each session, tumor cells may develop thermotolerance within 8 to 12 hours, with the temperature gradually returning to normal levels over the course of 2 to 4 days. The coding for this procedure encompasses not only the treatment itself but also the management of the overall treatment course, the physics planning involved, the insertion of temperature sensors, and the utilization of heat-generating sources. For reference, CPT® Code 77600 is designated for externally generated hyperthermia treatment targeting a superficial area, defined as a depth of 4 cm or less.
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The procedure of externally generated hyperthermia is indicated for the treatment of various tumor types, particularly when targeting specific conditions that benefit from elevated temperatures. The following are the explicitly provided indications for this procedure:
The procedure for externally generated hyperthermia involves several key steps that ensure effective treatment of the targeted tumor cells. The following procedural steps are outlined:
Following the hyperthermia treatment, patients can expect a recovery period during which the body gradually returns to its normal temperature. It is common for tumor cells to develop thermotolerance within 8 to 12 hours after the session, which may affect the efficacy of subsequent treatments. The normal temperature of the treated area typically returns to baseline levels over the course of 2 to 4 days. Patients are advised to follow any specific post-procedure care instructions provided by their healthcare team, which may include monitoring for any unusual symptoms or side effects. Regular follow-up appointments may be scheduled to assess the overall effectiveness of the treatment and to plan for any additional sessions as part of the comprehensive treatment strategy.
| Short Descr | HYPERTHERMIA EXT GEN DEEP | Medium Descr | HYPERTHERMIA EXTERNALLY GENERATED DEEP | Long Descr | Hyperthermia, externally generated; deep (ie, heating to depths greater than 4 cm) | Status Code | Restricted Coverage | Global Days | XXX - Global Concept Does Not Apply | PC/TC Indicator (26, TC) | 1 - Diagnostic Tests for Radiology Services | Multiple Procedures (51) | 0 - No 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 | Procedure or Service, Not Discounted when Multiple | ASC Payment Indicator | Radiology service paid separately when provided integral to a surgical procedure on ASC list; payment based on OPPS relative payment weight. | Type of Service (TOS) | 6 - Therapeutic Radiology | Berenson-Eggers TOS (BETOS) | P7B - Oncology - other | MUE | 1 | CCS Clinical Classification | 211 - Therapeutic radiology |
| 26 | Professional component: certain procedures are a combination of a physician or other qualified health care professional component and a technical component. when the physician or other qualified health care professional component is reported separately, the service may be identified by adding modifier 26 to the usual procedure number. | 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. | 77 | Repeat procedure by another physician or other qualified health care professional: it may be necessary to indicate that a basic procedure or service was repeated by another physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 77 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | CR | Catastrophe/disaster related | GC | This service has been performed in part by a resident under the direction of a teaching physician | LT | Left side (used to identify procedures performed on the left side of the body) | X4 | Episodic/focused services: for reporting services by clinicians who provide focused care on particular types of treatment limited to a defined period and circumstance; the patient has a problem, acute or chronic, that will be treated with surgery, radiation, or some other type of generally time-limited intervention; reporting clinician service examples include but are not limited to, the orthopedic surgeon performing a knee replacement and seeing the patient through the postoperative period |
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| 2025-01-01 | Changed | Short and Medium Descriptions changed. |
| 2024-01-01 | Changed | Guideline added. |
| 2018-01-01 | Note | AMA Guideline removed. |
| 2017-01-01 | Changed | Moderate (Conscious) Sedation flag removed. See new Moderate Sedation category. |
| 2013-01-01 | Changed | Guideline information changed. |
| Pre-1990 | Added | Code added. |
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