CPT® Code 96913

1. Indications

The procedure of photochemotherapy (CPT® Code 96913) is indicated for the treatment of severe photoresponsive dermatoses. These conditions are characterized by their responsiveness to light therapy and may include the following:

• Psoriasis A chronic autoimmune condition that leads to the rapid growth of skin cells, resulting in scaling on the skin's surface.
• Eczema A term for a group of conditions that cause the skin to become inflamed or irritated, often leading to itchy and red patches.
• Vitiligo A skin disorder that causes patches of skin to lose their pigment, resulting in lighter areas on the skin.
• Mycosis fungoides A type of skin lymphoma that presents with patches, plaques, or tumors on the skin.

2. Procedure

The procedure for photochemotherapy involves several critical steps to ensure effective treatment of the indicated dermatoses. Each step is designed to maximize the therapeutic benefits while ensuring patient safety.

• Step 1: Medication Administration The process begins with the administration of psoralen, a medication that increases the skin's sensitivity to UVA light. This medication is typically given orally approximately two hours before the patient is exposed to UVA light. This timing is essential as it allows the psoralen to circulate in the bloodstream and adequately prepare the skin for the subsequent light therapy.
• Step 2: Application of Coal Tar (Goeckerman Therapy) In cases where Goeckerman therapy is utilized, coal tar is applied to the affected areas of the skin. This application is intended to enhance the effectiveness of the light therapy by providing a protective barrier and additional therapeutic benefits to the skin.
• Step 3: UVA Light Exposure Following the medication administration and, if applicable, the coal tar application, the patient is placed in a UVA light booth. The duration of exposure to the UVA light is determined based on the specific nature of the dermatosis being treated. The patient remains under direct supervision of the physician throughout this exposure to ensure safety and monitor for any adverse reactions.
• Step 4: Post-Treatment Care After the light therapy session, the physician may apply dressings to the treated areas of the skin as needed. This step is crucial for protecting the skin and promoting healing, particularly in cases where the skin may be sensitive or irritated following treatment.

3. Post-Procedure

Post-procedure care following photochemotherapy is essential for optimal recovery and management of the treated skin areas. Patients are typically monitored for any immediate reactions to the treatment, and the physician may provide specific instructions regarding skin care. This may include recommendations for moisturizing the skin, avoiding sun exposure, and using gentle cleansers. The application of dressings, if performed, helps to protect the skin and can aid in the healing process. Patients may also be scheduled for follow-up appointments to assess the effectiveness of the treatment and make any necessary adjustments to their therapy regimen.