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Photodynamic therapy (PDT) is a medical treatment that utilizes a light-activated drug to target and destroy abnormal tissue, particularly in the lungs and gastrointestinal tract. The process begins with the administration of a photosensitive drug, such as Photofrin, which is delivered intravenously approximately 48 hours before the procedure. This drug is absorbed by various body tissues, including cancerous or abnormal cells. Following this, during a separate endoscopic procedure, either gastrointestinal endoscopy or bronchoscopy, a low-intensity laser is applied to the affected area. The light from the laser activates the drug, leading to a chemical reaction that results in the destruction of the targeted abnormal tissue. It is important to note that CPT® Code 96570 is used to report the first 30 minutes of photodynamic therapy, while CPT® Code 96571 is designated for each additional 15 minutes of therapy performed beyond the initial time frame.
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The indications for photodynamic therapy (PDT) primarily include the treatment of abnormal tissue in the lungs and gastrointestinal tract. This therapy is particularly relevant for patients with certain types of cancer or precancerous conditions where traditional treatment methods may not be as effective. The use of PDT is indicated when there is a need to ablate or destroy abnormal tissue that has absorbed the photosensitive drug, allowing for targeted treatment with minimal damage to surrounding healthy tissue.
The procedure for photodynamic therapy involves several key steps that ensure the effective application of the treatment. Initially, the patient receives an intravenous injection of a light-activated drug, such as Photofrin, approximately 48 hours prior to the planned PDT. This timing is crucial as it allows the drug to be absorbed by the body tissues, particularly targeting any cancerous or abnormal cells. Following this preparation, the patient undergoes a separate endoscopic procedure, which may be either gastrointestinal endoscopy or bronchoscopy, depending on the location of the abnormal tissue. During this procedure, a low-intensity laser is directed at the area where the abnormal tissue is located. The light emitted from the laser activates the photosensitive drug that has been absorbed by the abnormal cells. This activation triggers a reaction that leads to the destruction of the cancerous or abnormal tissue. It is important to note that the first 30 minutes of this therapy is reported using CPT® Code 96570, while any additional time spent on the procedure is reported with CPT® Code 96571 for each subsequent 15-minute interval.
After the photodynamic therapy procedure, patients may require monitoring for any immediate side effects or complications related to the treatment. Common post-procedure care includes observing the patient for signs of adverse reactions to the light-activated drug or the laser application. Patients may experience localized swelling, redness, or discomfort at the treatment site. It is essential to provide instructions regarding sun exposure, as the photosensitive drug can make the skin more sensitive to light for a period following the procedure. Follow-up appointments may be scheduled to assess the effectiveness of the treatment and to monitor the patient's recovery and any potential need for additional therapy.
| Short Descr | PHOTODYNAMIC TX ADDL 15 MIN | Medium Descr | PDT NDSC ABL ABNOR TISS VIA ACTIVJ RX A 15 MIN | Long Descr | Photodynamic therapy by endoscopic application of light to ablate abnormal tissue via activation of photosensitive drug(s); each additional 15 minutes (List separately in addition to code for endoscopy or bronchoscopy procedures of lung and gastrointestinal tract) | Status Code | Active Code | Global Days | ZZZ - Code Related to Another Service | 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) | 1 - Statutory 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 | Items and Services Packaged into APC Rates | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P8B - Endoscopy - upper gastrointestinal | MUE | 2 | CCS Clinical Classification | 174 - Other non-OR therapeutic procedures on skin and breast |
This is an add-on code that must be used in conjunction with one of these primary codes.
| 31641 | MPFS Status: Active Code APC J1 ASC A2 CPT Assistant Article Illustration for Code Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with destruction of tumor or relief of stenosis by any method other than excision (eg, laser therapy, cryotherapy) | 43229 | MPFS Status: Active Code APC J1 ASC J8 Esophagoscopy, flexible, transoral; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed) | 43270 | CPT Resequenced MPFS Status: Active Code APC J1 ASC J8 Esophagogastroduodenoscopy, flexible, transoral; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed) | 96570 | Addon Code MPFS Status: Active Code APC N PUB 100 CPT Assistant Article Photodynamic therapy by endoscopic application of light to ablate abnormal tissue via activation of photosensitive drug(s); first 30 minutes (List separately in addition to code for endoscopy or bronchoscopy procedures of lung and gastrointestinal tract) |
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| 2011-01-01 | Changed | Short description changed. Guideline information changed. |
| 2010-01-01 | Changed | Code description changed. |
| 2000-01-01 | Added | First appearance in code book in 2000. |
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