CPT® Code 0546T

Official Description

Radiofrequency spectroscopy, real time, intraoperative margin assessment, at the time of partial mastectomy, with report

Common Language Description

Radiofrequency spectroscopy is a diagnostic procedure utilized during partial mastectomy to assess the margins of excised breast tissue in real time. This technique is crucial for identifying positive margins, which indicate the presence of malignant cells at the edges of the resected tissue. By employing a hand-held probe, surgeons can detect the unique electromagnetic properties of different tissue types, which vary based on their structural and molecular characteristics. The procedure involves applying the probe to the surgically resected specimen, where it measures the electromagnetic scatter, reflectance, and absorbance of the tissue. The probe transmits readings that indicate whether the tissue is positive (malignant) or negative (benign). This allows for immediate feedback during surgery, enabling the surgeon to excise additional breast tissue if a positive reading is detected. The entire assessment of most surgical specimens can typically be completed in approximately five minutes, facilitating timely decision-making during the surgical procedure. However, it is important to note that radiofrequency spectroscopy is not applicable to specimen shavings or within the breast cavity of the patient, limiting its use to intact tissue specimens.

1. Indications

Radiofrequency spectroscopy is indicated for use during partial mastectomy procedures to assess the surgical margins of excised breast tissue. The primary indications for this procedure include:

Positive Margins Identification of malignant cells at the edges of the resected tissue, necessitating further excision.
Real-Time Assessment The need for immediate feedback during surgery to guide the surgeon in making decisions about additional tissue removal.
Partial Mastectomy Utilization in conjunction with lumpectomy surgeries to ensure complete removal of cancerous tissue.

2. Procedure

The procedure of radiofrequency spectroscopy involves several key steps to ensure accurate assessment of the excised breast tissue margins. These steps include:

Application of the Probe The surgeon applies a hand-held radiofrequency spectroscopy probe directly to the surface of the surgically resected specimen. This probe is designed to detect the electromagnetic properties of the tissue, which vary based on its cellular composition.
Real-Time Measurement As the probe contacts the tissue, it measures the electromagnetic scatter, reflectance, and absorbance. The device transmits a reading indicating whether the tissue is positive (malignant) or negative (benign). This process is repeated across different areas of the specimen to ensure comprehensive assessment.
Assessment Completion The entire analysis of most surgical specimens is typically completed within about five minutes. This rapid assessment allows the surgeon to make informed decisions during the procedure.
Further Resection if Necessary If a positive reading is obtained, indicating the presence of malignant cells, the surgeon can perform targeted further resection of the affected area to ensure complete removal of cancerous tissue.

3. Post-Procedure

After the radiofrequency spectroscopy procedure, the surgeon will evaluate the results of the margin assessment. If additional tissue has been excised based on positive readings, the surgical site will be closed according to standard surgical protocols. Patients may be monitored for any immediate post-operative complications, and standard post-operative care will be provided. Follow-up appointments will be scheduled to discuss pathology results and any further treatment options if necessary. It is essential to ensure that the patient understands the importance of follow-up care and any additional imaging or treatments that may be required based on the surgical findings.

Short Descr	RF SPECTRSC NTRAOP MRGN ASMT
Medium Descr	RF SPECTRSC R-T INTRAOP MRGN ASSMT TM PRTL MAST
Long Descr	Radiofrequency spectroscopy, real time, intraoperative margin assessment, at the time of partial mastectomy, with report
Status Code	Carriers Price the Code
Global Days	YYY - Carrier Determines Whether Global Concept Applies
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	Items and Services Packaged into APC Rates
Berenson-Eggers TOS (BETOS)	none
MUE	2

XU	Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
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.
AS	Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery
LT	Left side (used to identify procedures performed on the left side of the body)
RT	Right side (used to identify procedures performed on the right side of the body)