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Transperineal laser ablation (TPLA) is a medical procedure designed to treat benign prostatic hyperplasia (BPH), a condition characterized by the enlargement of the prostate gland that can lead to lower urinary tract symptoms in men. This minimally invasive technique utilizes targeted laser energy to thermally destroy hyperplastic prostate tissue while preserving the surrounding healthy glandular tissue. The procedure is performed on an outpatient basis, which means that patients can typically return home the same day, and it is associated with a lower risk of side effects compared to more invasive surgical options. TPLA can be repeated if necessary, making it a flexible treatment option for managing BPH. During the procedure, the laser energy is absorbed by the prostate tissue, generating heat that induces necrosis of the targeted areas within seconds. The effectiveness of the treatment is influenced by several factors, including the temperature, duration of heat transfer, and the depth of light distribution, which are determined by the specific wavelength of the laser used. To facilitate the procedure, a Foley catheter is placed to ensure proper drainage of urine. An ultrasound probe is typically inserted into the rectum to provide imaging guidance, and the procedure is usually performed under intravenous sedation combined with local anesthetic for patient comfort. A percutaneous catheter is inserted through the perineum to deliver an optical fiber equipped with a diffusing tip and a diode laser, which is surrounded by a cooling system connected to a flow circuit of sterile saline at room temperature. Using contrast-enhanced ultrasonography or MRI-fused images, the physician positions two to four laser fibers bilaterally in the transition zone of the prostate, parallel to the urethra, utilizing a needle guiding system. Once the fibers are correctly positioned, the needle is retracted to expose the fiber tips to the targeted tissue. If a medial lobe is present, a needle and laser fiber may also be placed there. The laser is initially activated at a lower power to confirm proper placement before the full treatment begins. Throughout the procedure, the physician closely monitors tissue necrosis and the temperature surrounding the treatment area to ensure safety. The laser delivery system is designed to automatically terminate the laser application if the temperatures at critical structures exceed predetermined limits. After the procedure is completed, the Foley catheter is removed, and the patient is monitored for a period before being discharged. It is important to report CPT® Code 0714T for cases involving a prostate volume of less than 50 mL, while CPT® Code 0867T should be used for prostate volumes greater than or equal to 50 mL.
© Copyright 2025 Coding Ahead. All rights reserved.
The transperineal laser ablation of benign prostatic hyperplasia (BPH) is indicated for the treatment of lower urinary tract symptoms in men caused by the enlargement of the prostate gland. The specific indications for this procedure include:
The transperineal laser ablation procedure involves several key steps to ensure effective treatment of benign prostatic hyperplasia. The procedural steps are as follows:
After the completion of the transperineal laser ablation procedure, the Foley catheter is removed. The patient is then monitored for a period to ensure there are no immediate complications or adverse effects from the procedure. It is essential to observe the patient for any signs of urinary retention or infection. Once the monitoring period is complete and the patient is stable, they are discharged with appropriate post-procedure care instructions. Follow-up appointments may be scheduled to assess the effectiveness of the treatment and to manage any ongoing symptoms related to benign prostatic hyperplasia.
| Short Descr | TPLA B9 PRST8 HYPRPLSA<50ML | Medium Descr | TPLA B9 PROSTATIC HYPERPLASIA PRST8 VOL<50 ML | Long Descr | Transperineal laser ablation of benign prostatic hyperplasia, including imaging guidance; prostate volume less than 50 mL | Status Code | Carriers Price the Code | Global Days | YYY - Carrier Determines Whether Global Concept Applies | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard 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) | 1 - Statutory 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 | Hospital Part B services paid through a comprehensive APC | ASC Payment Indicator | Non office-based surgical procedure added in CY 2008 or later; payment based on OPPS relative payment weight. | Berenson-Eggers TOS (BETOS) | none | MUE | 1 |
| 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 53 | Discontinued procedure: under certain circumstances, the physician or other qualified health care professional may elect to terminate a surgical or diagnostic procedure. due to extenuating circumstances or those that threaten the well being of the patient, it may be necessary to indicate that a surgical or diagnostic procedure was started but discontinued. this circumstance may be reported by adding modifier 53 to the code reported by the individual for the discontinued procedure. note: this modifier is not used to report the elective cancellation of a procedure prior to the patient's anesthesia induction and/or surgical preparation in the operating suite. for outpatient hospital/ambulatory surgery center (asc) reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | LT | Left side (used to identify procedures performed on the left side of the body) |
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| 2025-01-01 | Changed | First appearance of change in codebook. |
| 2024-07-01 | Changed | Short, Medium, and Long Descriptions changed. |
| 2023-01-01 | Added | First appearance in codebook. |
| 2022-07-01 | Added | Code added. |
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