How To Use CPT Code 76965

CPT 76965 describes the use of ultrasonic guidance for interstitial radioelement application. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 76965?

CPT 76965 is used to describe the placement of a radioactive element in the interstitial space to destroy a tumor. This procedure involves the use of ultrasonic guidance to accurately place the radioelement. The provider uses high-frequency sound waves to visualize the tumor and guide the placement of the needle.

2. Official Description

The official description of CPT code 76965 is: ‘Ultrasonic guidance for interstitial radioelement application.’

3. Procedure

1. The provider preps and drapes the patient and applies gel to the area being studied to improve visualization.
2. Using a transducer, the provider transmits high-frequency sound waves through the tissues to create an image on a receiving unit.
3. The provider locates the tumor using the ultrasound images and advances a needle to place the radioelement at the tumor site.

4. Qualifying circumstances

CPT 76965 is used when a provider uses ultrasonic guidance to place a radioactive element in the interstitial space to treat a tumor. The procedure is typically performed by a radiologist or other qualified healthcare professional. The patient must have a tumor that can be treated with interstitial radioelement application.

5. When to use CPT code 76965

CPT code 76965 should be used when the provider uses ultrasonic guidance to place a radioactive element in the interstitial space to treat a tumor. It should not be used for other types of procedures or when a different guidance method is used.

6. Documentation requirements

To support a claim for CPT 76965, the provider must document the following information:

• Patient’s diagnosis and the need for interstitial radioelement application
• Details of the ultrasonic guidance procedure, including the use of a transducer and gel
• Date and time of the procedure
• Location of the tumor and the placement of the radioelement
• Any complications or additional procedures performed
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 76965, ensure that the procedure was performed using ultrasonic guidance for interstitial radioelement application. It should not be reported with other codes unless there are specific circumstances that warrant additional codes. Modifier 52 may be appended to indicate a reduced service if the provider only performs the professional component of the procedure.

8. Historical information

CPT 76965 was added to the Current Procedural Terminology system on January 1, 1996. There have been no updates to the code since its addition.

9. Examples

1. A radiologist using ultrasonic guidance to place a radioactive element in the interstitial space to treat a breast tumor.
2. A surgeon using ultrasonic guidance to place a radioactive element in the interstitial space to treat a liver tumor.
3. An oncologist using ultrasonic guidance to place a radioactive element in the interstitial space to treat a prostate tumor.
4. A radiation oncologist using ultrasonic guidance to place a radioactive element in the interstitial space to treat a brain tumor.
5. A urologist using ultrasonic guidance to place a radioactive element in the interstitial space to treat a bladder tumor.
6. A gynecologist using ultrasonic guidance to place a radioactive element in the interstitial space to treat a cervical tumor.
7. A neurosurgeon using ultrasonic guidance to place a radioactive element in the interstitial space to treat a spinal tumor.
8. An orthopedic surgeon using ultrasonic guidance to place a radioactive element in the interstitial space to treat a bone tumor.
9. A dermatologist using ultrasonic guidance to place a radioactive element in the interstitial space to treat a skin tumor.
10. A gastroenterologist using ultrasonic guidance to place a radioactive element in the interstitial space to treat a pancreatic tumor.