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Transurethral destruction of prostate tissue by radiofrequency thermotherapy, commonly referred to as transurethral needle ablation (TUNA), is a minimally invasive procedure designed to alleviate symptoms associated with benign prostatic hypertrophy (BPH). BPH is a condition characterized by the enlargement of the prostate gland, which can lead to urinary difficulties such as increased frequency, urgency, and obstructed urine flow. During this procedure, the patient remains awake and is positioned in a dorsal lithotomy stance, which facilitates access to the urethra. To ensure patient comfort, an antiseptic solution is applied to the penis, and a local anesthetic, typically 10-20 mL of 1-2% lidocaine gel, is instilled into the urethra. This local anesthesia helps to minimize discomfort during the procedure. A rectal probe may be utilized to monitor the temperature of the prostate tissue throughout the treatment, ensuring that the applied heat is effective yet safe. A specialized catheter is then inserted into the prostatic urethra, through which an interstitial radiofrequency needle is deployed into the prostatic tissue. The needle contains bipolar electrodes that are activated by a radiofrequency machine, generating low-wave radiofrequency energy. This energy produces heat ranging from 60 to 100 degrees Celsius, effectively destroying excess prostatic tissue within a matter of minutes. To protect the surrounding urethral tissue from thermal damage, water is circulated through the catheter to cool the urethra during the procedure. The needle is systematically withdrawn and repositioned to treat all lobes of the prostate, ensuring comprehensive treatment. Upon completion of the procedure, the treatment catheter is removed, and a Foley catheter may be inserted transurethrally if necessary for post-procedure care.
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The transurethral destruction of prostate tissue by radiofrequency thermotherapy is indicated for the treatment of benign prostatic hypertrophy (BPH). This condition is characterized by the non-cancerous enlargement of the prostate gland, which can lead to various urinary symptoms that significantly impact the quality of life for affected individuals.
The procedure for transurethral destruction of prostate tissue by radiofrequency thermotherapy involves several key steps that ensure effective treatment while prioritizing patient safety and comfort.
Following the transurethral destruction of prostate tissue by radiofrequency thermotherapy, patients may experience some discomfort, which is typically managed with analgesics. It is common for patients to have a Foley catheter in place for a short period to facilitate urinary drainage and monitor for any complications. Patients are advised to follow up with their healthcare provider to assess the effectiveness of the procedure and to address any ongoing symptoms. Additionally, they should be informed about potential side effects, such as urinary retention or infection, and instructed on signs to watch for that may require immediate medical attention.
| Short Descr | PROSTATIC RF THERMOTX | Medium Descr | TRURL DSTRJ PRSTATE TISS RF THERMOTH | Long Descr | Transurethral destruction of prostate tissue; by radiofrequency thermotherapy | 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) | 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 | Office-based surgical procedure added to ASC list in CY 2008 or later with MPFS nonfacility PE RVUs; payment based on MPFS nonfacility PE RVUs. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P1G - Major procedure - Other | MUE | 1 | CCS Clinical Classification | 113 - Transurethral resection of prostate (TURP) |
| 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). | 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. | GC | This service has been performed in part by a resident under the direction of a teaching physician |
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| 1998-01-01 | Added | First appearance in code book in 1998. |
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