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The procedure described by CPT® Code 0421T involves transurethral waterjet ablation of the prostate, a minimally invasive technique aimed at treating benign prostatic hypertrophy (BPH) that results in lower urinary tract symptoms (LUTS) due to bladder outlet obstruction. This innovative approach utilizes water-jet hydrodissection, also known as aqua ablation, which employs a high-velocity stream of saline to selectively ablate prostate tissue. The procedure is guided by transrectal ultrasound imaging, allowing the surgeon to accurately map the target area and program a robotic system to ensure precise contours and depth of tissue removal. The use of electromechanical control enhances the precision of the ablation process, while real-time ultrasound guidance aids in monitoring the procedure's progress. Additionally, the water jet technique not only ablates glandular tissue but also collects it for laboratory analysis post-procedure. The procedure may necessitate additional interventions such as meatotomy, internal urethrotomy, and urethral calibration or dilation to facilitate access to the prostate. Furthermore, the inclusion of control of post-operative bleeding, as well as the potential use of a laser beam for surface coagulation and hemostasis, underscores the comprehensive nature of this procedure. It is important to note that vasectomy and cystourethroscopy are also included in the scope of this procedure when performed, highlighting the multifaceted approach to managing BPH and associated urinary symptoms.
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The transurethral waterjet ablation of the prostate is indicated for patients suffering from benign prostatic hypertrophy (BPH) that leads to lower urinary tract symptoms (LUTS) associated with bladder outlet obstruction. This procedure is particularly suitable for individuals who experience significant urinary difficulties due to the enlargement of the prostate gland, which can cause symptoms such as urinary frequency, urgency, weak stream, and incomplete bladder emptying.
The transurethral waterjet ablation procedure involves several key steps to ensure effective treatment of BPH. Initially, the patient is positioned appropriately, and transrectal ultrasound imaging is utilized to visualize the prostate and map the target area for ablation. This imaging allows the surgeon to program a robotic system with precise tissue contours and depth, ensuring that the ablation is targeted and effective.
After the transurethral waterjet ablation procedure, patients are typically monitored for any immediate post-operative complications, including bleeding. Control of post-operative bleeding is an integral part of the procedure, ensuring that any bleeding is managed effectively. Patients may experience some discomfort or urinary symptoms as they recover, and follow-up appointments are essential to assess the success of the procedure and the patient's recovery. The collection of ablated tissue for laboratory analysis may provide additional insights into the patient's condition and guide further treatment if necessary. Overall, the recovery process is generally straightforward, with many patients experiencing significant improvement in urinary symptoms following the procedure.
| Short Descr | WATERJET PROSTATE ABLTJ CMPL | Medium Descr | TRANSURETHRAL WATERJET ABLATION PROSTATE COMPL | Long Descr | Transurethral waterjet ablation of prostate, including control of post-operative bleeding, including ultrasound guidance, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal urethrotomy are included when performed) | Status Code | Carriers Price the Code | Global Days | XXX - Global Concept Does Not Apply | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 0 - No payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 0 - Payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Hospital Part B services paid through a comprehensive APC | ASC Payment Indicator | Device-intensive procedure added to ASC list in CY 2008 or later; paid at adjusted rate. | Berenson-Eggers TOS (BETOS) | P1G - Major procedure - Other | MUE | 1 |
| GC | This service has been performed in part by a resident under the direction of a teaching physician | GA | Waiver of liability statement issued as required by payer policy, individual case | 22 | Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service. | 53 | Discontinued procedure: under certain circumstances, the physician or other qualified health care professional may elect to terminate a surgical or diagnostic procedure. due to extenuating circumstances or those that threaten the well being of the patient, it may be necessary to indicate that a surgical or diagnostic procedure was started but discontinued. this circumstance may be reported by adding modifier 53 to the code reported by the individual for the discontinued procedure. note: this modifier is not used to report the elective cancellation of a procedure prior to the patient's anesthesia induction and/or surgical preparation in the operating suite. for outpatient hospital/ambulatory surgery center (asc) reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 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. | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | 82 | Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s). | CC | Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed) | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | GX | Notice of liability issued, voluntary under payer policy | GY | Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit | GZ | Item or service expected to be denied as not reasonable and necessary | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
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| 2017-01-01 | Added | First appearance in codebook. |
| 2016-01-01 | Added | Added |
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