CPT® Code 0197T | Case2Code

Code deleted, see 77387

Official Description

Intra-fraction localization and tracking of target or patient motion during delivery of radiation therapy (eg, 3D positional tracking, gating, 3D surface tracking), each fraction of treatment

Common Language Description

The CPT® Code 0197T refers to the process of intra-fraction localization and tracking of target or patient motion during the delivery of radiation therapy. This procedure utilizes advanced technology to ensure that the radiation beam is accurately directed at the tumor while accounting for any movement of the patient. The common language description highlights the use of a patient-position and motion-detection device, which plays a crucial role in monitoring the patient's position and movement throughout the radiation treatment session. With the evolution of radiation therapy techniques, such as intensity modulated radiation therapy (IMRT) and image guided radiation therapy (IGRT), the ability to deliver higher doses of radiation with precision has significantly improved. The effectiveness of these advanced therapies relies heavily on the accurate positioning of the patient and the clinician's capability to track any motion that may occur during treatment. To facilitate this, new intra-fraction localization and tracking devices have been developed. These devices assist clinicians in monitoring patient position and tracking motion during the actual delivery of radiation. Prior to the commencement of radiation therapy, a scanner is employed to capture images of the treatment area or the entire body surface. This imaging data is then analyzed and stored by computer software, creating a reference for optimal patient positioning. During the radiation treatment, the device continuously monitors the patient's motion against the previously acquired images. If the patient moves beyond the established tolerances, the system alerts the radiation technologist, prompting a pause in treatment. The patient is then repositioned correctly before the treatment session resumes. It is important to note that this code is reported for each fraction of treatment, emphasizing the need for precise localization and tracking throughout the entire course of radiation therapy.

1. Indications

The CPT® Code 0197T is indicated for use in situations where precise localization and tracking of the patient or target motion is essential during the delivery of radiation therapy. The following conditions may warrant the application of this procedure:

Radiation Therapy Treatment: This code is utilized during the administration of radiation therapy, particularly in cases where the tumor's position may change due to patient movement.
Intensity Modulated Radiation Therapy (IMRT): IMRT techniques require accurate patient positioning to ensure that high doses of radiation are delivered precisely to the tumor while minimizing exposure to surrounding healthy tissues.
Image Guided Radiation Therapy (IGRT): IGRT relies on real-time imaging to adjust the treatment plan based on the patient's position, making intra-fraction localization critical for effective treatment delivery.

2. Procedure

The procedure associated with CPT® Code 0197T involves several key steps to ensure accurate localization and tracking of the patient during radiation therapy:

Step 1: Pre-Treatment Imaging: Before the radiation therapy begins, a scanner is employed to capture detailed images of the treatment area or the entire body surface. This imaging is crucial for establishing a baseline reference for patient positioning.
Step 2: Data Analysis and Storage: The images obtained from the scanner are analyzed using specialized computer software. This software processes the data and stores it, creating a reference that will be used to determine the optimal position for the patient during treatment.
Step 3: Patient Positioning: Based on the analyzed data, the patient is positioned accurately for the treatment session. This positioning is critical to ensure that the radiation beam targets the tumor effectively.
Step 4: Motion Monitoring During Treatment: During the delivery of radiation therapy, the intra-fraction localization and tracking device continuously monitors the patient's motion. It compares the patient's current position to the previously stored images to detect any deviations.
Step 5: Response to Motion: If the device detects that the patient has moved outside the allowed tolerances, it alerts the radiation technologist. Treatment is then paused, and the patient is repositioned to the correct alignment before resuming the session.

3. Post-Procedure

After the completion of the radiation therapy session utilizing CPT® Code 0197T, the patient may be monitored for any immediate side effects related to the treatment. It is essential to ensure that the patient is stable and in the correct position before concluding the session. Follow-up care may include additional imaging or assessments to evaluate the effectiveness of the treatment and to plan for subsequent sessions. The use of intra-fraction localization and tracking devices enhances the overall safety and efficacy of radiation therapy, contributing to better treatment outcomes.

Short Descr	INTRAFRACTION TRACK MOTION
Medium Descr	IFXJ LOCLZ&TRAKG TRGT/PT MTN DUR RADTX EA FXJ
Long Descr	Intra-fraction localization and tracking of target or patient motion during delivery of radiation therapy (eg, 3D positional tracking, gating, 3D surface tracking), each fraction of treatment
Status Code	Carriers Price the Code
Global Days	XXX - Global Concept Does Not Apply
PC/TC Indicator (26, TC)	0 - Physician Service Code
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	Items and Services Packaged into APC Rates
Type of Service (TOS)	6 - Therapeutic Radiology
Berenson-Eggers TOS (BETOS)	P6C - Minor procedures - other (Medicare fee schedule)
MUE	Not applicable/unspecified.
CCS Clinical Classification	211 - Therapeutic radiology