CPT® Code 77424

1. Indications

Intraoperative radiation therapy (IORT) is indicated for the treatment of various malignant tumors. The specific indications for this procedure include:

• Gastric Tumors Tumors located in the stomach that require targeted radiation treatment during surgical intervention.
• Pancreatic Tumors Malignant growths in the pancreas that can be treated with IORT to minimize damage to surrounding tissues.
• Colonic Tumors Tumors in the colon that necessitate precise radiation delivery during surgery.
• Rectal Tumors Malignant tumors in the rectal area that can benefit from intraoperative radiation therapy.
• Anal Tumors Tumors located in the anal region that are treated with IORT to enhance treatment efficacy.
• Cervical Tumors Malignant tumors of the cervix that may be addressed with intraoperative radiation.
• Uterine Tumors Tumors in the uterus that require targeted radiation during surgical procedures.
• Ovarian Tumors Malignant growths in the ovaries that can be treated with IORT.
• Prostatic Tumors Tumors affecting the prostate gland that may be treated using this technique.
• Bladder Tumors Malignant tumors in the bladder that can be addressed with intraoperative radiation therapy.
• Kidney Tumors Tumors located in the kidneys that may benefit from targeted radiation treatment.
• Soft Tissue Sarcomas Malignant tumors of soft tissues that can be treated with IORT to improve outcomes.

2. Procedure

The procedure for intraoperative radiation therapy (IORT) involves several critical steps to ensure effective treatment delivery. The first step is the surgical removal of the tumor, where the surgeon aims to excise as much of the malignant tissue as possible. This is typically performed during a separately reportable surgical procedure. Following the tumor removal, the surgeon carefully maneuvers healthy organs away from the radiation field to protect them from exposure. This positioning is crucial as it minimizes the risk of radiation damage to surrounding healthy tissues. Once the area is prepared, specialized tubes are utilized to focus the radiation directly on the tumor site. This targeted approach allows for the delivery of a concentrated dose of radiation precisely where it is needed. The radiation treatment is then administered, utilizing low energy x-ray radiation, which is the focus of CPT® code 77424. This type of IORT is generally performed with a portable miniature x-ray source, ensuring that the radiation is delivered effectively and safely during the surgical procedure.

3. Post-Procedure

After the completion of the intraoperative radiation therapy (IORT), patients may require specific post-procedure care to monitor for any potential side effects or complications. The expected recovery process will vary depending on the extent of the surgical procedure and the individual patient's health status. It is essential for healthcare providers to observe the patient for any signs of radiation-related side effects, which may include localized swelling, redness, or discomfort at the treatment site. Additionally, follow-up appointments will be necessary to assess the effectiveness of the treatment and to monitor for any recurrence of the tumor. Patients may also receive guidance on managing any post-operative symptoms and recommendations for rehabilitation or supportive care as needed. Overall, the post-procedure phase is critical for ensuring optimal recovery and long-term outcomes following IORT.