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Intraoperative radiation treatment management, as denoted by CPT® Code 77469, refers to a specialized approach in which radiation therapy is administered directly during a surgical procedure. This technique, known as intraoperative radiation therapy (IORT), allows for the delivery of concentrated doses of radiation to malignant tumors while they are still accessible and visible to the surgeon. The primary advantage of IORT is its ability to target tumors effectively while minimizing exposure to surrounding healthy tissues and organs, thereby reducing the risk of radiation-induced damage. This is particularly beneficial in cases where tumors are located in sensitive areas of the body. Common types of malignant tumors treated with IORT include those found in the gastric, pancreatic, colonic, rectal, and anal regions. Additionally, IORT is utilized for cervical, uterine, ovarian, and prostatic tumors, as well as tumors affecting the bladder, kidney, and soft tissue sarcomas. The management of IORT encompasses several critical components, including the calculation and review of dosimetry, which ensures that the correct radiation dose is delivered to the tumor. It also involves the individual delivery of doses tailored to the patient's specific needs, as well as the establishment of treatment parameters. Pre-treatment setup is an essential part of the management process, which includes positioning the patient appropriately and assessing the placement of immobilization devices, radiation blocks, or wedges to optimize treatment effectiveness. Furthermore, the management of IORT extends beyond the administration of radiation; it includes coordinating the patient's overall care, evaluating their response to treatment, and reviewing relevant laboratory tests and imaging studies to ensure comprehensive patient management.
© Copyright 2025 Coding Ahead. All rights reserved.
The indications for intraoperative radiation treatment management (CPT® Code 77469) include the following malignant tumors:
The procedure for intraoperative radiation treatment management involves several critical steps to ensure effective delivery of radiation therapy during surgery. The first step is Pre-treatment Setup, which includes positioning the patient appropriately on the operating table to facilitate access to the tumor site. This may involve the use of immobilization devices to keep the patient stable and ensure accurate targeting of the radiation. Additionally, radiation blocks or wedges may be utilized to protect surrounding healthy tissues from unnecessary radiation exposure.
Following the setup, the next step is Dosimetry Calculation and Review. This involves calculating the appropriate radiation dose required for the specific tumor type and size, as well as reviewing the dosimetry to confirm that the planned treatment parameters are accurate. This step is crucial for ensuring that the tumor receives the intended dose while minimizing exposure to adjacent healthy structures.
Once the dosimetry is confirmed, the Individual Dose Delivery can commence. During this phase, the radiation is delivered directly to the tumor while it is exposed during the surgical procedure. The surgeon and radiation oncologist work closely to monitor the delivery of radiation, ensuring that it is administered precisely according to the calculated parameters.
After the radiation has been delivered, the final step involves Post-treatment Evaluation. This includes assessing the patient's response to the treatment, which may involve reviewing lab tests and imaging films to monitor for any immediate effects or complications. Coordinating the patient's overall care is also essential, as it ensures that any necessary follow-up treatments or interventions are planned based on the patient's condition following IORT.
Post-procedure care following intraoperative radiation treatment management includes monitoring the patient for any immediate side effects or complications resulting from the radiation therapy. Patients may require follow-up imaging studies to assess the effectiveness of the treatment and to evaluate the tumor's response. Additionally, healthcare providers will review laboratory tests to monitor the patient's overall health and any potential impacts on organ function due to the radiation. Coordination of ongoing care is essential, as patients may need further treatments or interventions based on their recovery and response to the IORT. Regular follow-up appointments will be scheduled to ensure comprehensive management of the patient's condition and to address any concerns that may arise during the recovery process.
| Short Descr | IO RADIATION TX MANAGEMENT | Medium Descr | INTRAOPERATIVE RADIATION TREATMENT MANAGEMENT | Long Descr | Intraoperative radiation treatment management | Status Code | Active Code | Global Days | XXX - Global Concept Does Not Apply | PC/TC Indicator (26, TC) | 0 - Physician Service 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 | Code Not Recognized by OPPS when submitted on Outpatient Hospital Part B Bill Type (12x/13x) | Type of Service (TOS) | 4 - Diagnostic Radiology | Berenson-Eggers TOS (BETOS) | I4B - Imaging/procedure - other | MUE | 1 | CCS Clinical Classification | 211 - Therapeutic radiology |
| 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. | CR | Catastrophe/disaster related | GC | This service has been performed in part by a resident under the direction of a teaching physician | GZ | Item or service expected to be denied as not reasonable and necessary | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study |
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| 2012-01-01 | Added | Added |
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