CPT® Code 0663T | Case2Code

Official Description

Scalp cooling, mechanical; placement of device, monitoring, and removal of device (List separately in addition to code for primary procedure)

Common Language Description

Scalp cooling therapy is a specialized procedure designed to mitigate hair loss associated with chemotherapy treatments. This therapy employs a mechanical device, commonly referred to as a scalp cooling cap, which is strategically placed on the patient's head. The primary mechanism of action involves the cooling of the scalp, which leads to the constriction of blood vessels. This vasoconstriction effectively reduces blood flow to the hair follicles, thereby limiting the amount of chemotherapy drugs that can enter these cells. Since chemotherapy targets all rapidly dividing cells, including hair follicle cells, the use of a cooling cap can significantly decrease the likelihood of hair loss, which typically manifests approximately two weeks after the commencement of chemotherapy. This procedure is particularly beneficial for women undergoing treatment for breast cancer, as it can help preserve their hair, thereby enhancing their self-esteem and maintaining their privacy during a challenging time. The cooling cap is constructed from flexible silicone and is filled with a coolant that circulates through it, ensuring a consistent temperature around 32 degrees Fahrenheit. The cap is worn for a total of approximately two hours: 30 minutes prior to chemotherapy, during the infusion, and for up to 90 minutes afterward. It is important to note that the initial personal measurement and calibration of the cap, which is a separate service, is reported using CPT® Code 0662T, while CPT® Code 0663T is used to report the placement, monitoring, and removal of the cooling cap during each chemotherapy session.

1. Indications

The indications for scalp cooling therapy primarily include the following:

Chemotherapy-Induced Hair Loss This procedure is indicated for patients undergoing chemotherapy, particularly those at high risk of hair loss, such as women with breast cancer.

2. Procedure

The procedure for scalp cooling therapy involves several key steps that ensure the effective application of the cooling cap:

Step 1: Preparation Prior to the application of the cooling cap, the patient is prepared for the procedure. This includes explaining the process and ensuring the patient is comfortable with the use of the device.
Step 2: Fitting the Cooling Cap The cooling cap, which is made of flexible silicone and contains circulating coolant, is fitted closely to the patient's head. A neoprene cover is then placed over the cap to insulate it, absorb any condensation, and ensure a snug fit.
Step 3: Connection to the Cooling System A conduit connected under the chin links the cap to a computer system that controls the temperature and circulation of the coolant. This system is crucial for maintaining the cap at a consistent temperature of approximately 32 degrees Fahrenheit.
Step 4: Monitoring The patient wears the cooling cap for a total of about two hours: 30 minutes before chemotherapy, during the infusion, and for up to 90 minutes afterward. Throughout this time, the healthcare provider monitors the patient to ensure comfort and the proper functioning of the cooling system.
Step 5: Removal of the Cooling Cap After the designated time, the cooling cap is carefully removed. The healthcare provider assesses the scalp for any adverse reactions and provides post-procedure instructions as necessary.

3. Post-Procedure

Post-procedure care for scalp cooling therapy includes monitoring the patient for any immediate reactions to the cooling cap. Patients are advised to report any discomfort or unusual symptoms following the removal of the cap. Additionally, they may be provided with guidance on hair care during and after chemotherapy to further support hair retention. Follow-up appointments may be scheduled to assess the effectiveness of the scalp cooling therapy and to discuss any further treatments or adjustments needed for subsequent chemotherapy sessions.

Short Descr	SCALP COOL PLMT MNTR RMVL
Medium Descr	SCALP COOLING PLACEMENT MNTR & REMOVAL OF DEVICE
Long Descr	Scalp cooling, mechanical; placement of device, monitoring, and removal of device (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
Berenson-Eggers TOS (BETOS)	none
MUE	1

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

96409	MPFS Status: Active Code APC S Physician Quality Reporting PUB 100 CPT Assistant Article Chemotherapy administration; intravenous, push technique, single or initial substance/drug
96411	Addon Code MPFS Status: Active Code APC S Physician Quality Reporting PUB 100 CPT Assistant Article Chemotherapy administration; intravenous, push technique, each additional substance/drug (List separately in addition to code for primary procedure)
96413	MPFS Status: Active Code APC S Physician Quality Reporting PUB 100 CPT Assistant Article Chemotherapy administration, intravenous infusion technique; up to 1 hour, single or initial substance/drug
96415	Addon Code MPFS Status: Active Code APC S Physician Quality Reporting PUB 100 CPT Assistant Article Chemotherapy administration, intravenous infusion technique; each additional hour (List separately in addition to code for primary procedure)
96416	MPFS Status: Active Code APC S Physician Quality Reporting PUB 100 CPT Assistant Article Chemotherapy administration, intravenous infusion technique; initiation of prolonged chemotherapy infusion (more than 8 hours), requiring use of a portable or implantable pump
96417	Addon Code MPFS Status: Active Code APC S Physician Quality Reporting PUB 100 CPT Assistant Article Chemotherapy administration, intravenous infusion technique; each additional sequential infusion (different substance/drug), up to 1 hour (List separately in addition to code for primary procedure)