© Copyright 2025 American Medical Association. All rights reserved.
The procedure described by CPT® Code 77778 refers to interstitial radiation source application, which is a specialized technique used in the treatment of cancer. This method involves the precise placement of radioactive materials directly into or near malignant tissues, with the primary goal of destroying cancerous cells while minimizing damage to the surrounding healthy tissues. This targeted approach is essential in cancer treatment, as it allows for higher doses of radiation to be delivered directly to the tumor, enhancing the effectiveness of the treatment while reducing the risk of adverse effects on adjacent normal tissues.
In preparation for the application of the radioactive source, medical professionals utilize various tools such as applicator needles, catheters, or tubes, which are inserted into the target area. The correct positioning of these devices is confirmed through imaging techniques, including x-ray, computed tomography (CT), magnetic resonance imaging (MRI), or ultrasound (US). Once the applicators are in place, the radioactive source, which may come in the form of seeds, capsules, or wires, is delivered to the designated treatment area.
The application of the radioactive source can be performed using different techniques. The manual (hand) afterloading technique involves the operator manually placing the radioactive material into the applicators after they have been positioned. Alternatively, the machine (automated remote) afterloading technique utilizes specialized equipment to deliver the radioactive source, enhancing safety and precision. In certain cases, a method known as "hot loading" may be employed, where the applicator is pre-loaded with the radioactive source before being inserted into the patient, further streamlining the procedure.
Depending on the treatment plan, the radioactive source may be left in place temporarily, allowing for the delivery of a prescribed dose of radiation before removal, or it may be implanted permanently, with the source material gradually decaying over the lifespan of the implant. The comprehensive nature of this procedure, as indicated by Code 77778, includes not only the application of the radiation source but also the necessary supervision, handling, and loading of the radioactive material, ensuring that all aspects of the procedure are conducted safely and effectively.
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The interstitial radiation source application procedure is indicated for various types of cancer where localized treatment is necessary. The following conditions may warrant the use of this procedure:
The interstitial radiation source application involves several critical procedural steps to ensure effective treatment. Each step is essential for the successful delivery of radiation to the targeted area.
After the interstitial radiation source application, patients may require specific post-procedure care to ensure optimal recovery and effectiveness of the treatment. Monitoring for any side effects or complications is essential, and patients may be advised on activity restrictions based on the type of radioactive source used and the duration of its placement. Follow-up appointments are typically scheduled to assess the treatment's effectiveness and manage any potential side effects. Additionally, patients may receive instructions regarding care for the insertion sites and any necessary precautions related to radiation safety, especially if the radioactive source is left in place permanently.
| Short Descr | APPLY INTERSTIT RADIAT COMPL | Medium Descr | INTERSTITIAL RADIATION SOURCE APPLIC COMPLEX | Long Descr | Interstitial radiation source application, complex, includes supervision, handling, loading of radiation source, when performed | Status Code | Active Code | Global Days | 000 - Endoscopic or Minor Procedure | PC/TC Indicator (26, TC) | 1 - Diagnostic Tests for Radiology Services | 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 | ASC Payment Indicator | Radiology service paid separately when provided integral to a surgical procedure on ASC list; payment based on OPPS relative payment weight. | Type of Service (TOS) | 6 - Therapeutic Radiology | Berenson-Eggers TOS (BETOS) | P7A - Oncology - radiation therapy | MUE | 1 | CCS Clinical Classification | 211 - Therapeutic radiology |
| 26 | Professional component: certain procedures are a combination of a physician or other qualified health care professional component and a technical component. when the physician or other qualified health care professional component is reported separately, the service may be identified by adding modifier 26 to the usual procedure number. | TC | Technical component; under certain circumstances, a charge may be made for the technical component alone; under those circumstances the technical component charge is identified by adding modifier 'tc' to the usual procedure number; technical component charges are institutional charges and not billed separately by physicians; however, portable x-ray suppliers only bill for technical component and should utilize modifier tc; the charge data from portable x-ray suppliers will then be used to build customary and prevailing profiles | 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. | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service | 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. | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 77 | Repeat procedure by another physician or other qualified health care professional: it may be necessary to indicate that a basic procedure or service was repeated by another physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 77 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | CR | Catastrophe/disaster related | GC | This service has been performed in part by a resident under the direction of a teaching physician | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study | Q6 | Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area | SG | Ambulatory surgical center (asc) facility service | XP | Separate practitioner, a service that is distinct because it was performed by a different practitioner |
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| 2016-01-01 | Changed | Description Changed |
| 2001-01-01 | Changed | Code description changed. |
| Pre-1990 | Added | Code added. |
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