CPT® Code 86153

1. Indications

The procedure associated with CPT® Code 86153 is indicated for the following conditions:

• Detection of Circulating Tumor Cells This test is performed to identify the presence of circulating tumor cells in patients diagnosed with various types of cancer, which can provide critical information regarding the metastatic spread of the disease.
• Prognostic Assessment The enumeration of circulating tumor cells can help determine the prognosis of the disease, as the presence of these cells often correlates with a lower survival rate.
• Treatment Monitoring The test may be utilized to monitor the effectiveness of ongoing treatment regimens in cancer patients, allowing for adjustments based on the presence or absence of circulating tumor cells.
• Specific Cancer Types This procedure is particularly relevant for cancers such as breast, colorectal, prostate, renal, bladder, and non-small cell lung cancer, where the detection of circulating tumor cells can influence treatment decisions.

2. Procedure

The procedure for CPT® Code 86153 involves several key steps that ensure accurate enumeration and identification of circulating tumor cells in a fluid specimen.

• Sample Collection A fluid specimen, typically blood, is obtained from the patient. This is usually performed through a separately reportable venipuncture, where a needle is inserted into a vein to draw blood. In cases where bone marrow or lymphatic fluid is required, appropriate methods such as bone marrow biopsy or other techniques are employed to collect the necessary samples.
• Cell Enumeration Once the fluid specimen is collected, it undergoes a cell enumeration process. This may involve the use of a cell search method, which identifies circulating tumor cells based on specific immunologic markers. A positive result is indicated if five or more tumor cells are detected in the sample. Alternatively, morphological appearance techniques may be used, which require microscopic examination to visualize and identify the tumor cells based on their characteristics.
• Physician Interpretation After the enumeration process, a physician may be required to interpret the results. This interpretation is crucial for understanding the clinical significance of the findings, particularly in relation to the patient's cancer diagnosis and treatment plan. The physician's report will summarize the results and provide insights into the implications for the patient's care.

3. Post-Procedure

Post-procedure care for patients undergoing the test associated with CPT® Code 86153 typically involves monitoring for any immediate complications related to the sample collection, such as bruising or discomfort at the venipuncture site. Patients may be advised to follow up with their healthcare provider to discuss the results of the test and any necessary changes to their treatment plan based on the findings. The physician's interpretation and report will guide further management decisions, including potential additional testing or adjustments to therapy, depending on the presence and quantity of circulating tumor cells detected.