Reporting Ablation of Malignant Prostate Tissue (55880)

 CPT Assistant, September 2021, Volume 31, Issue 9, page 11

For the Current Procedural Terminology (CPT®) 2021 code set, a new Category I code (55880) was established to report transrectal ablation of the prostate using high intensity-focused ultrasound (HIFU), including ultrasound guidance. This article provides an overview of the intent and use of this new code.

Other Procedures

 

55880 

Ablation of malignant prostate tissue, transrectal, with high intensity-focused ultrasound (HIFU), including ultrasound guidance

Prior to 2021, an unlisted CPT code was used to report prostate ablation for the treatment of prostate cancer using HIFU. As the code descriptor for code 55880 includes ultrasound guidance, do not report an additional code for ultrasound guidance.

The following clinical example and procedural description reflect the typical clinical scenario for which this new code would be appropriately reported.

Clinical Example (55880)

A 67-year-old male with prostate cancer presents for high intensity-focused ultrasound (HIFU) prostate tissue ablation.

Description of Procedure (55880)

After induction of general anesthesia, place a urethral catheter. Perform a digital rectal examination to confirm absence of fecal material. Insert a treatment probe that is covered with a condom for cool fluid circulation in the rectum. Obtain real-time ultrasound images of the prostate in the sagittal and transverse planes to ensure that treatment would be technically feasible (eg, the anterior gland is accessible and there is no acoustic shadowing). Perform treatment planning with custom software that enables the prostate to be divided into anterior, middle, and posterior zones. Just prior to each treatment, remove the urethral catheter and then replace before the next treatment. During HIFU treatment, use real-time ultrasound of the apex of the prostate to enable identification and avoidance of the external urinary sphincter. Perform multiple individual HIFU micro-treatments (ablations) to treat the entire gland, each one requiring individual monitoring and individual physician intervention in order to treat the entire gland. Upon completion of HIFU treatment, remove the rectal probe. Confirm the urethral catheter is draining sufficiently. Place a belladonna and opium (B&O) suppository for urgency symptoms and apply rectal pressure as needed for any rectal bleeding.