How To Use CPT Code 55920

CPT 55920 describes the placement of needles or catheters into pelvic organs and/or genitalia (except prostate) 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 55920?

CPT 55920 can be used to describe the placement of needles or catheters into pelvic organs and/or genitalia (except prostate) for subsequent interstitial radioelement application. This code is used when the provider inserts needles or catheters into the cancerous pelvic organ or genitalia to facilitate brachytherapy, also known as internal cancer radiotherapy.

2. Official Description

The official description of CPT code 55920 is: ‘Placement of needles or catheters into pelvic organs and/or genitalia (except prostate) for subsequent interstitial radioelement application.’

3. Procedure

1. The provider prepares the patient and administers anesthesia.
2. The procedure begins with the patient in the lithotomy position.
3. Ultrasonic guidance may be used to assist in guiding the needles or catheters into the pelvic organ or genitalia through the perineum.
4. The provider places the needles or catheters into the cancerous pelvic organ or genitalia.
5. This procedure is performed to facilitate the later placement of radioactive seeds for radiation therapy.

4. Qualifying circumstances

Patients eligible for CPT 55920 are those who require brachytherapy for the treatment of cancer in the pelvic organs or genitalia (except prostate). The provider must use needles or catheters to deliver the radioactive seeds for interstitial radioelement application. This code should not be used for the placement of needles or catheters into the prostate, uterine tandems and/or vaginal ovoids for clinical brachytherapy, or Heyman capsules for clinical brachytherapy.

5. When to use CPT code 55920

CPT code 55920 should be used when the provider places needles or catheters into the pelvic organs and/or genitalia (except prostate) for subsequent interstitial radioelement application. It should not be used for other types of brachytherapy procedures or for the placement of needles or catheters into the prostate.

6. Documentation requirements

To support a claim for CPT 55920, the provider must document the following information:

• Patient’s diagnosis requiring brachytherapy
• Specific pelvic organ or genitalia where the needles or catheters were placed
• Date and details of the procedure, including the use of ultrasonic guidance if applicable
• Any additional radiotherapy devices placed during the same session
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 55920, ensure that the procedure involves the placement of needles or catheters into the pelvic organs and/or genitalia (except prostate) for subsequent interstitial radioelement application. Report this code only once, even if multiple needles are placed. If additional radiotherapy devices are placed during the same session, report the appropriate additional codes (57155 or 58346). Do not report CPT 55920 if the procedure involves the placement of needles or catheters into the prostate.

8. Historical information

CPT 55920 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 provider places needles into the pelvic organs of a patient with cervical cancer for subsequent interstitial radioelement application.
2. A provider inserts catheters into the genitalia of a patient with vulvar cancer for brachytherapy treatment.
3. A provider places needles into the pelvic organs of a patient with vaginal cancer for interstitial radioelement application.
4. A provider inserts catheters into the genitalia of a patient with penile cancer for subsequent brachytherapy.
5. A provider places needles into the pelvic organs of a patient with rectal cancer for interstitial radioelement application.
6. A provider inserts catheters into the genitalia of a patient with anal cancer for brachytherapy treatment.
7. A provider places needles into the pelvic organs of a patient with ovarian cancer for subsequent interstitial radioelement application.
8. A provider inserts catheters into the genitalia of a patient with testicular cancer for brachytherapy treatment.
9. A provider places needles into the pelvic organs of a patient with bladder cancer for interstitial radioelement application.
10. A provider inserts catheters into the genitalia of a patient with urethral cancer for subsequent brachytherapy.