CPT® Code 77422 | Case2Code

Official Description

High energy neutron radiation treatment delivery; single treatment area using a single port or parallel-opposed ports with no blocks or simple blocking

Common Language Description

High energy neutron radiation treatment, as described by CPT® Code 77422, involves the delivery of neutron beam therapy to a specific treatment area utilizing either a single port or parallel-opposed ports without the use of blocks or simple blocking. This specialized form of external beam radiation therapy is particularly beneficial for targeting non-operable tumors that exhibit resistance to traditional radiation treatments. The treatment can be applied to various anatomical sites, including the salivary glands, head and neck regions, bone structures, joints, and soft tissues. One of the key advantages of neutron beam therapy (NBT) is its high radiation biological effect, which is attributed to the prolonged activity of neutrons at the target site. This characteristic enhances the likelihood of damaging both strands of the DNA within cancer cells, thereby complicating their ability to survive or repair from the radiation exposure. However, it is important to note that NBT also carries an increased risk of radiation exposure to the surrounding normal tissues adjacent to the tumor. The technique of using a single port involves directing one neutron beam to deliver the radiation dose, which is typically employed for palliative care or for treating superficial lesions. In contrast, the parallel-opposed ports method utilizes two neutron beams, allowing for a smaller dose from one beam and a larger dose from the other, facilitating a more uniform distribution of the radiation dose along the central axis. This approach is particularly advantageous for treating tumors located in the head and neck region.

1. Indications

The indications for high energy neutron radiation treatment delivery (CPT® Code 77422) include the following:

Non-operable tumors that are resistant to conventional radiation therapy.
Salivary gland tumors that require targeted radiation treatment.
Head and neck tumors that necessitate precise radiation delivery.
Bone tumors that are not amenable to surgical intervention.
Joint tumors that require focused radiation therapy.
Soft tissue tumors that are difficult to treat with standard radiation methods.

2. Procedure

The procedure for high energy neutron radiation treatment delivery involves several key steps:

Step 1: Patient Preparation The patient is positioned appropriately to ensure optimal targeting of the treatment area. This may involve immobilization techniques to minimize movement during the procedure.
Step 2: Treatment Planning A detailed treatment plan is developed, which includes imaging studies to accurately locate the tumor and determine the appropriate radiation dose. This plan is crucial for ensuring that the neutron beams are directed precisely at the tumor while minimizing exposure to surrounding healthy tissues.
Step 3: Delivery of Radiation The high energy neutron radiation is delivered to the designated treatment area using either a single port or parallel-opposed ports. In the single port method, one neutron beam is utilized to administer the radiation dose, while in the parallel-opposed ports method, two neutron beams are employed to achieve a more uniform dose distribution.
Step 4: Monitoring Throughout the treatment, the patient's response is monitored to ensure that the radiation is being delivered effectively and safely. Adjustments may be made as necessary based on real-time feedback.
Step 5: Post-Treatment Assessment After the radiation delivery, the patient is assessed for any immediate side effects or complications. Follow-up appointments are scheduled to monitor the treatment's effectiveness and manage any potential adverse effects.

3. Post-Procedure

Post-procedure care following high energy neutron radiation treatment involves monitoring the patient for any immediate side effects, which may include fatigue, skin reactions, or localized discomfort in the treated area. Patients are advised to report any unusual symptoms or complications to their healthcare provider. Follow-up appointments are essential to evaluate the effectiveness of the treatment and to assess for any long-term effects on surrounding healthy tissues. Supportive care may be provided to manage any side effects experienced during recovery, and ongoing assessments will help guide further treatment decisions if necessary.

Short Descr	NEUTRON BEAM TX SIMPLE
Medium Descr	HIGH ENERGY NEUTRON RADJ TX DLVR 1 TX AREA
Long Descr	High energy neutron radiation treatment delivery; single treatment area using a single port or parallel-opposed ports with no blocks or simple blocking
Status Code	Carriers Price the Code
Global Days	XXX - Global Concept Does Not Apply
PC/TC Indicator (26, TC)	3 - Technical Component Only Code
Multiple Procedures (51)	0 - No 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)	0 - 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	Procedure or Service, Not Discounted when Multiple
Type of Service (TOS)	6 - Therapeutic Radiology
Berenson-Eggers TOS (BETOS)	P7A - Oncology - radiation therapy
MUE	Not applicable/unspecified.
CCS Clinical Classification	211 - Therapeutic radiology