CPT® Code 55862

1. Indications

The procedure associated with CPT® Code 55862 is indicated for patients requiring brachytherapy for prostate cancer. The specific indications for this procedure include:

• Prostate Cancer Treatment Patients diagnosed with localized prostate cancer who are candidates for brachytherapy as a treatment option.
• Assessment of Lymph Nodes Situations where there is a need to evaluate the status of pelvic lymph nodes, particularly in cases where there is suspicion of lymphatic spread of cancer.

2. Procedure

The procedure for CPT® Code 55862 involves several key steps that ensure the successful exposure of the prostate and the insertion of radioactive substances. The steps are as follows:

• Step 1: Surgical Approach The surgeon selects an appropriate surgical approach, either retropubic or perineal, to access the prostate gland. In the retropubic approach, an incision is made in the lower abdomen, and the bladder is carefully displaced to create access to the area behind the pubic bone. In the perineal approach, an incision is made in the perineal region to directly access the prostate.
• Step 2: Needle Placement Once access to the prostate is achieved, the surgeon may utilize a finger guide placed in the rectum to assist in the accurate placement of a hollow applicator needle into the prostate tissue. This step is crucial for ensuring that the radioactive seeds are delivered to the correct location within the prostate.
• Step 3: Radioactive Seed Implantation After the needle is positioned correctly, radioactive seeds are introduced through the needle and implanted into the prostate. The surgeon carefully withdraws the needle and repositions it in small millimeter increments to place additional seeds, ensuring comprehensive coverage of the target area. This process is repeated multiple times until the desired number of seeds is implanted.
• Step 4: Lymph Node Biopsy Concurrently, a limited pelvic lymphadenectomy is performed, which involves the biopsy of lymph nodes, typically focusing on the unilateral obturator lymph node chain(s). This step is essential for assessing the potential spread of cancer to the lymphatic system.

3. Post-Procedure

After the completion of the procedure, patients may require monitoring for any immediate complications related to the surgery or the implantation of radioactive seeds. Post-procedure care typically includes managing any discomfort or pain, monitoring for signs of infection, and ensuring proper healing of the surgical site. Patients may also receive specific instructions regarding activity restrictions and follow-up appointments to assess the effectiveness of the brachytherapy and the status of the lymph nodes. It is important for patients to adhere to follow-up care to monitor for any potential side effects or complications arising from the procedure.