How To Use CPT Code 20555

CPT code 20555 describes the placement of needles or catheters into muscle and/or soft tissue for subsequent interstitial radioelement application. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 20555?

CPT 20555 is used to describe the placement of needles or catheters into muscle and/or soft tissue for subsequent interstitial radioelement application. This procedure involves the insertion of small tubes into the affected area, through which radioactive seeds are inserted either immediately or at a later encounter. The seeds emit radiation that damages or destroys cancerous cells.

2. Official Description

The official description of CPT code 20555 is: ‘Placement of needles or catheters into muscle and/or soft tissue for subsequent interstitial radioelement application (at the time of or subsequent to the procedure).’ It is important to note that there are specific codes for interstitial radioelement application in other areas of the body, such as the breast, head and neck, prostate, and pelvic organs or genitalia.

3. Procedure

The procedure for CPT code 20555 involves the following steps:

1. The patient is appropriately prepped and anesthetized.
2. The healthcare provider inserts catheters or needles at the site of the malignancy, guided by radiological imaging.
3. The provider uses the catheters or needles as the delivery route for the radiotherapy elements or seeds.
4. The seeds may be inserted immediately or at a subsequent encounter.
5. The catheters or needles are secured in place.
6. Throughout the treatment phase, the provider may add or remove seeds as necessary.

4. Qualifying circumstances

CPT code 20555 is used for patients who require interstitial radioelement application for the treatment of certain cancers. The procedure involves the placement of needles or catheters into muscle and/or soft tissue. It is important to note that there are specific codes for interstitial radioelement application in other areas of the body, such as the breast, head and neck, prostate, and pelvic organs or genitalia.

5. When to use CPT code 20555

CPT code 20555 should be used when the healthcare provider is performing the placement of needles or catheters into muscle and/or soft tissue for subsequent interstitial radioelement application. It is important to use the appropriate code based on the specific area of the body being treated.

6. Documentation requirements

To support a claim for CPT code 20555, the healthcare provider must document the following information:

• Patient’s diagnosis and the need for interstitial radioelement application
• Specific details of the procedure, including the placement of needles or catheters
• Date and time of the procedure
• Any additional details or complications encountered during the procedure
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT code 20555, ensure that the procedure involves the placement of needles or catheters into muscle and/or soft tissue for subsequent interstitial radioelement application. It is important to use the appropriate code based on the specific area of the body being treated. Additionally, be aware of any specific guidelines or modifiers that may be required for accurate billing.

8. Historical information

CPT code 20555 was added to the Current Procedural Terminology system on January 1, 2008. There have been no updates to the code since its addition.

9. Examples

1. A healthcare provider inserts needles into the muscle and/or soft tissue of a patient’s leg for subsequent interstitial radioelement application to treat a cancerous tumor.
2. A patient undergoes the placement of catheters into the muscle and/or soft tissue of their abdomen for interstitial radioelement application to treat a malignant tumor.
3. A healthcare provider inserts needles into the muscle and/or soft tissue of a patient’s arm for subsequent interstitial radioelement application to target cancer cells.
4. A patient receives the placement of catheters into the muscle and/or soft tissue of their back for interstitial radioelement application to treat a localized tumor.
5. A healthcare provider inserts needles into the muscle and/or soft tissue of a patient’s chest for subsequent interstitial radioelement application to target cancerous cells.
6. A patient undergoes the placement of catheters into the muscle and/or soft tissue of their neck for interstitial radioelement application to treat a malignant tumor.
7. A healthcare provider inserts needles into the muscle and/or soft tissue of a patient’s abdomen for subsequent interstitial radioelement application to target cancer cells.
8. A patient receives the placement of catheters into the muscle and/or soft tissue of their leg for interstitial radioelement application to treat a localized tumor.
9. A healthcare provider inserts needles into the muscle and/or soft tissue of a patient’s arm for subsequent interstitial radioelement application to target cancerous cells.
10. A patient undergoes the placement of catheters into the muscle and/or soft tissue of their back for interstitial radioelement application to treat a malignant tumor.