CPT® Code 0354T

Official Description

Optical coherence tomography of breast, surgical cavity; interpretation and report, real-time or referred

Common Language Description

Optical coherence tomography (OCT) is a sophisticated, non-invasive imaging technique that is employed during surgical procedures to provide detailed visualization of the microscopic features of breast tissue and the surrounding area within the surgical cavity. This advanced imaging modality operates in real-time, utilizing high-resolution near-infrared light to capture images that reveal the microstructure of the tissue. The primary advantage of OCT is its ability to differentiate between normal low-scattering adipocytes, which are the typical fat cells found in breast tissue, and the high-scattering, heterogeneous patterned tissue that is indicative of tumor cells. By providing this level of detail, OCT assists surgeons in making informed decisions during breast surgeries, particularly in conserving healthy breast tissue while ensuring that clear surgical margins are achieved. The CPT® Code 0354T specifically pertains to the interpretation and reporting of the findings obtained from the optical coherence tomography procedure, distinguishing it from the real-time intraoperative imaging captured under CPT® Code 0353T.

1. Indications

Optical coherence tomography of the breast surgical cavity is indicated for the following conditions:

Breast Cancer Surgery This procedure is utilized during surgeries for breast cancer to assist in the identification of tumor margins and to ensure complete removal of cancerous tissue.
Assessment of Surgical Cavity OCT is indicated for evaluating the surgical cavity post-tumor excision to confirm the absence of residual tumor cells.
Tissue Preservation The technique is employed to aid in the conservation of healthy breast tissue during surgical interventions.

2. Procedure

The procedure for optical coherence tomography of the breast surgical cavity involves several key steps:

Preparation of the Surgical Site The surgical area is prepared, ensuring that the patient is positioned appropriately and that the surgical field is sterile. This preparation is crucial for the accuracy of the imaging and the safety of the patient.
Application of Optical Coherence Tomography The OCT device is then positioned to capture images of the surgical cavity. The high-resolution near-infrared light is directed at the tissue, allowing for real-time imaging of the microstructural features within the breast tissue.
Real-Time Imaging As the procedure progresses, the surgeon receives immediate feedback from the OCT images, which helps in assessing the tissue characteristics and determining the presence of any tumor cells or abnormalities.
Documentation of Findings After the imaging is completed, the results are documented, and a detailed report is generated. This report includes the interpretation of the images and any relevant findings that may impact the surgical approach or postoperative care.

3. Post-Procedure

Following the optical coherence tomography procedure, the surgeon will review the findings documented in the report to make informed decisions regarding further surgical actions or postoperative management. Patients may be monitored for any immediate complications related to the surgery, and follow-up care will be planned based on the results of the OCT imaging. The interpretation and report generated from the OCT procedure are essential for ensuring that the surgical goals, such as clear margins and tissue preservation, are achieved effectively.

Short Descr	OCT BREAST SURG CAVITY I&R
Medium Descr	OCT BREAST SURG CAVITY REAL TIME/REFERRED I&R
Long Descr	Optical coherence tomography of breast, surgical cavity; 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	2