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An open ablation of one or more liver tumors involves a surgical procedure where tumors located in the liver are targeted for destruction. This procedure is typically indicated for patients with liver tumors that may not be amenable to other forms of treatment. The process begins with a midline incision in the abdomen, allowing the surgeon access to the liver. During the operation, any adhesions that may obstruct the view or access to the liver are carefully lysed, utilizing both blunt and sharp dissection techniques. The abdominal cavity is thoroughly inspected to identify any extrahepatic tumors or other abnormalities that may be present. Once the liver is mobilized, all eight hepatic segments are inspected to locate the tumors. In this procedure, radiofrequency ablation is employed, which involves the use of a radiofrequency electrode needle that is guided into the center of the tumor using ultrasound guidance. The radiofrequency energy is then applied to heat the tumor to a specific temperature, which is maintained for a predetermined duration to ensure effective destruction of the tumor cells. After the heating cycle, the tissue is allowed to cool while the surgical team monitors the site to confirm that the entire tumor, along with a margin of healthy tissue, has been adequately destroyed. If necessary, the electrode needle may be repositioned at different angles or locations within the tumor to ensure complete necrosis. This process is repeated for any additional tumors present until all targeted tumors have been successfully ablated. Following the completion of the ablation, the surgical team releases any gas from the abdominal cavity, removes the laparoscope and surgical instruments, and closes the portal incisions to conclude the procedure.
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The open ablation of liver tumors is indicated for patients presenting with one or more liver tumors that require intervention. The specific indications for this procedure include:
The procedure for open ablation of liver tumors involves several critical steps to ensure effective treatment. The steps are as follows:
After the completion of the open ablation procedure, patients are typically monitored for any immediate complications. Post-procedure care may include pain management, monitoring for signs of infection, and ensuring that the patient is stable before discharge. Patients may be advised on activity restrictions and follow-up appointments to assess recovery and monitor for any recurrence of tumors. The expected recovery time can vary based on the individual patient's health and the extent of the procedure performed.
| Short Descr | OPEN ABLATE LIVER TUMOR RF | Medium Descr | ABLTJ OPN 1/> LVR TUM RF | Long Descr | Ablation, open, of 1 or more liver tumor(s); radiofrequency | Status Code | Active Code | Global Days | 090 - Major Surgery | 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) | 2 - Payment restriction for assistants at surgery does not apply to this procedure... | Co-Surgeons (62) | 1 - Co-surgeons could be paid, though supporting documentation is required... | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Inpatient Procedures, not paid under OPPS | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P1G - Major procedure - Other | MUE | 1 | CCS Clinical Classification | 99 - Other OR gastrointestinal therapeutic procedures |
| 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 62 | Two surgeons: when 2 surgeons work together as primary surgeons performing distinct part(s) of a procedure, each surgeon should report his/her distinct operative work by adding modifier 62 to the procedure code and any associated add-on code(s) for that procedure as long as both surgeons continue to work together as primary surgeons. each surgeon should report the co-surgery once using the same procedure code. if additional procedure(s) (including add-on procedure(s) are performed during the same surgical session, separate code(s) may also be reported with modifier 62 added. note: if a co-surgeon acts as an assistant in the performance of additional procedure(s), other than those reported with the modifier 62, during the same surgical session, those services may be reported using separate procedure code(s) with modifier 80 or modifier 82 added, as appropriate. | 22 | Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service. | 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). | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 78 | Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.) | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | 82 | Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s). | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | GC | This service has been performed in part by a resident under the direction of a teaching physician | GW | Service not related to the hospice patient's terminal condition | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| 2010-01-01 | Changed | Code description changed. |
| 2002-01-01 | Added | First appearance in code book in 2002. |
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