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The procedure described by CPT® Code 55860 involves the surgical exposure of the prostate gland through various approaches, specifically for the purpose of inserting a radioactive substance as part of brachytherapy treatment. Brachytherapy is a form of radiation therapy where radioactive seeds are implanted directly into or near a tumor, allowing for targeted treatment while minimizing exposure to surrounding healthy tissues. The surgical approach can be either retropubic, which involves an incision in the lower abdomen, or perineal, which involves an incision made in the perineal area. In the retropubic approach, the bladder is carefully displaced to access the area behind the pubic bone, allowing the surgeon to reach the prostate. During the procedure, the physician may utilize a finger guide placed in the rectum to accurately position a hollow applicator needle into the prostate tissue. Once the needle is correctly positioned, radioactive seeds are introduced through the needle and implanted into the prostate. The needle is then withdrawn and repositioned in small increments to place additional seeds, repeating this process multiple times to ensure adequate coverage of the target area. This procedure is critical in the management of prostate cancer, providing a localized treatment option that can lead to effective tumor control.
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The procedure associated with CPT® Code 55860 is indicated for the treatment of prostate cancer, particularly in cases where localized therapy is deemed appropriate. The following conditions may warrant the use of this procedure:
The procedure for CPT® Code 55860 involves several critical steps to ensure the successful insertion of radioactive seeds into the prostate. The following outlines the procedural steps:
After the completion of the procedure, patients are typically monitored for any immediate complications. Post-procedure care may include pain management, monitoring for signs of infection, and instructions for activity restrictions. Patients may experience some discomfort or urinary symptoms following the procedure, which should be discussed with their healthcare provider. Follow-up appointments are essential to assess the effectiveness of the treatment and to monitor for any potential side effects or complications related to the brachytherapy.
| Short Descr | SURGICAL EXPOSURE PROSTATE | Medium Descr | EXPOS PROSTATE ANY APPROACH INSJ RADIOACT SUBST | Long Descr | Exposure of prostate, any approach, for insertion of radioactive substance; | 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) | 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 | 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. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P1G - Major procedure - Other | MUE | 1 | CCS Clinical Classification | 118 - Other OR therapeutic procedures, male genital |
| 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. | GC | This service has been performed in part by a resident under the direction of a teaching physician |
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| 2016-01-01 | Note | AMA Guidelines changed. |
| 2011-01-01 | Changed | Short description changed. |
| 2010-01-01 | Changed | Code description changed. |
| Pre-1990 | Added | Code added. |
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