CPT® Code 0071T

1. Indications

The focused ultrasound ablation of uterine leiomyomata, as described by CPT® Code 0071T, is indicated for patients experiencing symptoms related to uterine fibroids. These symptoms may include:

• Heavy Menstrual Bleeding Excessive bleeding during menstruation that can lead to anemia and other complications.
• Pelvic Pain Discomfort or pain in the pelvic region caused by the presence of fibroids.
• Pressure Symptoms Symptoms such as urinary frequency, urgency, or incontinence due to pressure from the fibroids on surrounding organs.
• Abdominal Distension A feeling of fullness or swelling in the abdomen resulting from the growth of fibroids.

2. Procedure

The procedure for focused ultrasound ablation of uterine leiomyomata involves several critical steps to ensure effective treatment:

• Step 1: Patient Preparation The patient is positioned on the treatment table, and a three-plane localizer MR scan is performed to confirm proper alignment and positioning. This initial imaging is essential for accurately targeting the fibroids during the procedure.
• Step 2: Target Identification The specific leiomyoma to be treated is identified using the MR imaging system. This step is crucial for ensuring that the ultrasound energy is directed precisely at the fibroid.
• Step 3: Treatment Planning Advanced treatment software is utilized to determine the appropriate treatment routes and ablation dose delivery settings. 3D renderings and dose simulations are created and reviewed to finalize the treatment plan.
• Step 4: Conscious Sedation The procedure is performed under conscious sedation, allowing the patient to remain awake and able to communicate any sensations to the medical team throughout the process.
• Step 5: Sonication Continuous MR imaging is employed during the sonication phase, where high-intensity focused ultrasound is applied to the targeted fibroid. The ultrasound energy raises the temperature of the fibroid tissue to between 60 and 80 degrees Celsius, effectively destroying the fibroid.
• Step 6: Multiple Treatments If multiple leiomyomata are present, the above steps are repeated for each fibroid, ensuring that all targeted fibroids are treated effectively.

3. Post-Procedure

After the focused ultrasound ablation procedure, patients may experience some discomfort or mild pain, which can typically be managed with over-the-counter pain relief. Monitoring for any immediate complications is essential, and patients are usually advised to rest and avoid strenuous activities for a short period. Follow-up appointments may be scheduled to assess the effectiveness of the treatment and to monitor for any recurrence of symptoms. It is important for patients to report any unusual symptoms or concerns to their healthcare provider during the recovery phase.