CPT® Code 0443T | Case2Code

Official Description

Real-time spectral analysis of prostate tissue by fluorescence spectroscopy, including imaging guidance (List separately in addition to code for primary procedure)

Common Language Description

The procedure described by CPT® Code 0443T involves the use of real-time spectral analysis of prostate tissue through fluorescence spectroscopy, which is a technique employed to identify malignant prostate tissue. This procedure is particularly significant when performed in conjunction with a needle or punch prostate biopsy, as it enhances the accuracy of diagnosing prostate cancer. Fluorescence spectroscopy (FS) operates by analyzing naturally fluorescing endogenous proteins and enzymes present in body tissues. When these tissues are subjected to photon-electron stimulation, they scatter signals that can be measured. The concentration of endogenous fluorophores in prostate tissue varies depending on the presence of disease, making FS a valuable tool for quantifying these variations and identifying malignant lesions. During the procedure, a custom fluorometer, which is equipped with light-emitting diodes and a spectrometer, is utilized to read the fluorescence signals. This device interfaces with specialized software designed to differentiate between benign and malignant tissues, providing a histopathological grade for suspected malignant tumors. The procedure employs an optical biopsy needle that contains a built-in light-sensitive optical probe or sensor, along with fibers that facilitate tissue excitation and the collection of spectral data. This needle is advanced into the prostate under the guidance of fluorescence spectroscopy, allowing for real-time analysis. The ability to obtain spectral data in vivo significantly enhances the diagnostic yield of the biopsy sample, as it aids in recognizing suspicious areas within the prostate gland and improves the overall accuracy of prostate cancer diagnosis.

1. Indications

The procedure indicated by CPT® Code 0443T is performed for the following conditions:

Prostate Cancer Diagnosis The primary indication for this procedure is to assist in the diagnosis of prostate cancer by identifying malignant prostate tissue during a biopsy.
Suspicious Prostate Lesions It is indicated for cases where there are suspicious areas within the prostate gland that require further investigation to determine the presence of malignancy.

2. Procedure

The procedure involves several key steps to ensure accurate identification of malignant prostate tissue through fluorescence spectroscopy:

Step 1: Preparation The patient is prepared for the procedure, which includes obtaining informed consent and ensuring that the patient is in a suitable position for the biopsy. The area of the prostate is typically prepped and draped in a sterile manner to minimize the risk of infection.
Step 2: Imaging Guidance Imaging guidance is utilized to accurately locate the target areas within the prostate gland. This may involve the use of ultrasound or other imaging modalities to visualize the prostate and identify suspicious lesions.
Step 3: Optical Biopsy Needle Insertion An optical biopsy needle, equipped with a built-in light-sensitive optical probe and fibers, is advanced into the prostate under the guidance of fluorescence spectroscopy. This needle is designed to excite the tissue and collect spectral data for analysis.
Step 4: Fluorescence Spectroscopy Analysis Once the needle is in place, fluorescence spectroscopy is employed to analyze the tissue. The custom fluorometer reads the fluorescence signals emitted by the endogenous proteins and enzymes in the prostate tissue, differentiating between benign and malignant tissues based on the spectral data collected.
Step 5: Data Interpretation The acquired spectral data is processed by specialized software that interprets the signals to provide a histopathological grade for any suspected malignant tumors. This real-time analysis aids in making informed decisions regarding the biopsy sample.

3. Post-Procedure

After the procedure, the patient may be monitored for any immediate complications, such as bleeding or infection. It is essential to provide post-procedure care instructions, which may include recommendations for activity restrictions and signs of complications to watch for. The results of the fluorescence spectroscopy analysis, along with the biopsy findings, will be communicated to the patient and the referring physician to guide further management and treatment decisions.

Short Descr	R-T SPCTRL ALYS PRST8 TISS
Medium Descr	R-T SPCTRL ALYS PRST8 TISS FLUORESCENC SPCTRSCPY
Long Descr	Real-time spectral analysis of prostate tissue by fluorescence spectroscopy, including imaging guidance (List separately in addition to code for primary procedure)
Status Code	Carriers Price the Code
Global Days	ZZZ - Code Related to Another Service
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
ASC Payment Indicator	Packaged service/item; no separate payment made.
Berenson-Eggers TOS (BETOS)	P5E - Ambulatory procedures - other
MUE	1

This is an add-on code that must be used in conjunction with one of these primary codes.

55700

Male Edit MPFS Status: Active Code APC J1 ASC A2 CPT Assistant Article Illustration for Code Biopsy, prostate; needle or punch, single or multiple, any approach