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CPT®
77785

CPT® Code 77785
Deleted

Code deleted, see 77770, 77771, 77772

Official Description

Remote afterloading high dose rate radionuclide brachytherapy; 1 channel

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

Remote afterloading high dose rate (HDR) radionuclide brachytherapy is a specialized procedure used in the treatment of certain cancers. This technique involves the precise delivery of radioactive sources directly to the tumor site, allowing for high doses of radiation to be administered while minimizing exposure to surrounding healthy tissues. The term "remote afterloading" refers to the method by which the radioactive material is loaded into the applicators after they have been placed in the patient, ensuring that the physician can maintain a safe distance during the actual delivery of radiation. This procedure is typically performed in a controlled environment, where the patient is closely monitored throughout the process. The use of a remote afterloading machine allows for accurate timing and control of the radiation exposure, which is critical for the effectiveness of the treatment. The procedure is meticulously planned, often requiring separate isodose planning to determine the optimal placement and dosage of the radioactive source. The complexity of HDR brachytherapy is reflected in the coding, where the number of channels used to deliver the radioactive source is a key factor in determining the appropriate CPT® code for billing purposes.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

Remote afterloading high dose rate radionuclide brachytherapy is indicated for the treatment of various malignancies where localized radiation therapy is beneficial. The following conditions may warrant the use of this procedure:

  • Cancer Treatment This procedure is primarily performed for patients diagnosed with specific types of cancer, particularly those that are localized and can benefit from targeted radiation therapy.
  • Tumor Size and Location The procedure is indicated for tumors that are accessible for the placement of applicators, allowing for effective delivery of the radioactive source.
  • Patient Health Status Patients who are in a suitable health condition to undergo a procedure involving radiation therapy may be considered for HDR brachytherapy.

2. Procedure

The procedure for remote afterloading high dose rate radionuclide brachytherapy involves several critical steps to ensure effective treatment delivery:

  • Step 1: Brachytherapy Isodose Planning Prior to the procedure, a brachytherapy isodose planning session is conducted to determine the optimal placement and dosage of the radioactive source. This planning is essential for maximizing the treatment's effectiveness while minimizing exposure to surrounding healthy tissues.
  • Step 2: Applicator Placement The physician performs a separate procedure to implant empty cylinders or other applicators in and around the tumor site. This step is crucial as it establishes the pathway for the radioactive source to be delivered directly to the tumor.
  • Step 3: Inspection of Applicators After the applicators are placed, they are inspected for size, placement, and stability. Any necessary adjustments are made to ensure that the applicators are correctly positioned for optimal radiation delivery.
  • Step 4: Connection to Remote Afterloading Machine A transfer tube is selected and connected to the channel applicator in the remote afterloading machine. This connection is vital for the subsequent loading of the radioactive source.
  • Step 5: Monitoring the Patient The physician leaves the room to maintain safety while the patient is monitored visually and verbally throughout the procedure. This monitoring ensures the patient's well-being during the radiation delivery process.
  • Step 6: Loading the Radioactive Source The remote afterloading machine then loads the radioactive source into the previously placed applicators. Timers within the machine control the duration of exposure to the radioactive source, ensuring precise delivery of the radiation dose.
  • Step 7: Retracting the Radioactive Source Upon completion of the procedure, the radioactive source is retracted and placed in a safe position within the afterloading machine. This step is verified using a room radiation detector, followed by a patient radiation survey to ensure safety.
  • Step 8: Removal of Applicators Finally, the empty applicators are removed from the patient, concluding the procedure.

3. Post-Procedure

After the completion of remote afterloading high dose rate radionuclide brachytherapy, patients may require specific post-procedure care. This includes monitoring for any immediate side effects related to the radiation therapy, such as localized discomfort or changes in the treatment area. Patients are typically advised on follow-up appointments to assess the effectiveness of the treatment and to monitor for any potential complications. Additionally, safety protocols regarding radiation exposure may be discussed, including guidelines for interaction with others and any necessary precautions to take in the days following the procedure. The overall recovery process will vary based on individual patient factors and the extent of the treatment performed.
Short Descr HDR BRACHYTX 1 CHANNEL
Medium Descr REMOTE AFTLD RADIONUCLIDE BRACHYTX 1 CHANNEL
Long Descr Remote afterloading high dose rate radionuclide brachytherapy; 1 channel
Status Code Active Code
Global Days XXX - Global Concept Does Not Apply
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
Type of Service (TOS) 6 - Therapeutic Radiology
Berenson-Eggers TOS (BETOS) P5E - Ambulatory procedures - other
MUE Not applicable/unspecified.
CCS Clinical Classification 211 - Therapeutic radiology
Date
Action
Notes
2016-01-01 Deleted Code deleted, see 77770, 77771, 77772
2011-01-01 Changed Short description changed.
2009-01-01 Added -
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