CPT® Code 0352T

Official Description

Optical coherence tomography of breast or axillary lymph node, excised tissue, each specimen; interpretation and report, real-time or referred

Common Language Description

Optical coherence tomography (OCT) is a sophisticated, non-invasive imaging technique that provides high-resolution images of the microscopic features of breast tissue and axillary lymph nodes. This advanced imaging modality employs near-infrared light to capture detailed images in real-time, allowing for the differentiation between lymphatic tissue and adipose (fat) tissue. The procedure is particularly valuable during surgical interventions, as it can reveal critical structures within lymph nodes, such as germinal centers and intranodal lymph and blood vessels. Additionally, OCT plays a crucial role in identifying metastatic disease, which is the spread of cancer cells to lymph nodes. By utilizing OCT during breast cancer surgeries, surgeons can minimize the number of non-diseased lymph nodes that are removed, thereby reducing the risk of complications such as lymphedema, a condition characterized by swelling due to lymph fluid accumulation. Furthermore, OCT aids in monitoring tumor margins, which allows for the conservation of healthy breast tissue during excision, ultimately leading to less extensive breast reconstruction. While CPT® Code 0351T is designated for the real-time intraoperative application of OCT, CPT® Code 0352T specifically pertains to the physician's interpretation of the OCT findings and the subsequent report generated from the analysis of each specimen.

1. Indications

Optical coherence tomography (OCT) is indicated for use in the evaluation of breast tissue and axillary lymph nodes during surgical procedures. The primary indications for performing OCT include:

Breast Cancer Surgery The procedure is utilized to assess tumor margins and ensure the complete removal of malignant tissue while preserving healthy breast tissue.
Evaluation of Lymph Nodes OCT is indicated for the examination of axillary lymph nodes to differentiate between metastatic disease and non-diseased lymphatic tissue, aiding in surgical decision-making.

2. Procedure

The procedure for optical coherence tomography of breast or axillary lymph node excised tissue involves several key steps:

Specimen Preparation The excised tissue specimens from the breast or axillary lymph nodes are prepared for imaging. This may involve placing the specimens in a suitable medium to maintain their integrity during the imaging process.
Imaging Process The OCT device is then utilized to capture high-resolution images of the prepared specimens. Near-infrared light is directed onto the tissue, and the reflected light is analyzed to create detailed images that reveal the microscopic structure of the tissue.
Interpretation of Images After the imaging is completed, the physician interprets the OCT images. This interpretation involves identifying key features such as lymphatic structures, adipose tissue, and any signs of metastatic disease.
Report Generation Following the interpretation, a comprehensive report is generated that summarizes the findings from the OCT analysis. This report is crucial for guiding further treatment decisions and surgical planning.

3. Post-Procedure

Post-procedure care following the optical coherence tomography involves monitoring the patient for any immediate complications related to the surgical procedure. The findings from the OCT interpretation and report are reviewed to inform the next steps in the patient's treatment plan. It is essential for the healthcare team to discuss the results with the patient, including any implications for further surgery or treatment based on the presence of metastatic disease or the adequacy of tumor margins. Additionally, the healthcare provider may provide guidance on recovery and any necessary follow-up appointments to ensure optimal patient outcomes.

Short Descr	OCT BRST/NODE I&R PER SPEC
Medium Descr	OCT BREAST OR AXILL NODE SPECIMEN I&R
Long Descr	Optical coherence tomography of breast or axillary lymph node, excised tissue, each specimen; interpretation and report, real-time or referred
Status Code	Carriers Price the Code
Global Days	YYY - Carrier Determines Whether Global Concept Applies
PC/TC Indicator (26, TC)	9 - Not Applicable
Multiple Procedures (51)	9 - Concept does not apply.
Bilateral Surgery (50)	9 - Concept does not apply.
Physician Supervisions	09 - Concept does not apply.
Assistant Surgeon (80, 82)	9 - Concept does not apply.
Co-Surgeons (62)	9 - Concept does not apply.
Team Surgery (66)	9 - Concept does not apply.
Diagnostic Imaging Family	99 - Concept Does Not Apply
APC Status Indicator	Code Not Recognized by OPPS when submitted on Outpatient Hospital Part B Bill Type (12x/13x)
Berenson-Eggers TOS (BETOS)	I1C - Standard imaging - breast
MUE	5

59	Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25.
77	Repeat procedure by another physician or other qualified health care professional: it may be necessary to indicate that a basic procedure or service was repeated by another physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 77 to the repeated procedure or service. note: this modifier should not be appended to an e/m service.
RT	Right side (used to identify procedures performed on the right side of the body)