CPT® Code 77787

Deleted

1. Indications

The procedure of 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 be effectively treated with targeted radiation therapy.
• Localized Tumors Indications include tumors that are confined to a specific area, allowing for precise delivery of radiation to minimize exposure to surrounding healthy tissues.
• Recurrent Tumors It may also be indicated for patients with recurrent tumors where previous treatments have not been successful, providing a second-line treatment option.

2. Procedure

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

• Brachytherapy Isodose Planning Initially, a brachytherapy isodose planning session is conducted to determine the optimal placement and dosage of the radioactive source. This planning is essential for achieving the desired therapeutic effect while protecting adjacent healthy tissues.
• Implantation of Applicators Following the planning, the physician performs a separate reportable procedure to implant empty cylinders or applicators into and around the tumor. This step is crucial as it sets the stage for the subsequent delivery of the radioactive source.
• Inspection of Applicators Once the applicators are in place, they are inspected for size, placement, and stability. Any necessary adjustments are made to ensure that the applicators are correctly positioned to deliver the radiation effectively.
• Connection to Remote Afterloading Machine A transfer tube is then selected and connected to the channel applicator in the remote afterloading machine. This connection is vital for the subsequent loading of the radioactive source.
• Monitoring During Procedure The physician exits the room, and the patient is monitored visually and verbally throughout the procedure to ensure safety and comfort.
• Loading of 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 treatment.
• 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.
• 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, specific post-procedure care is necessary to ensure patient safety and monitor for any potential complications. Patients are typically observed for a period to assess for any immediate adverse effects related to the procedure. Follow-up appointments are scheduled to evaluate the effectiveness of the treatment and to monitor for any signs of recurrence or complications. Patients may also receive instructions regarding activity restrictions and any necessary precautions related to radiation exposure, particularly in the immediate aftermath of the procedure. It is essential for healthcare providers to ensure that patients understand the importance of adhering to follow-up care and any prescribed treatment plans.