2025 CPT code 49327
(Active) Effective Date: N/A Surgery - Laparoscopic Procedures on the Abdomen, Peritoneum, and Omentum Surgery Feed
Laparoscopy, surgical; with placement of interstitial device(s) for radiation therapy guidance (e.g., fiducial markers, dosimeter), intra-abdominal, intrapelvic, and/or retroperitoneum, including imaging guidance, if performed, single or multiple.
Modifiers may be applicable, such as modifier 59 (Distinct Procedural Service) to indicate that the placement of the interstitial device is separate and distinct from other procedures performed during the same operative session.
Medical necessity for this code is established when the placement of interstitial devices is necessary for accurate targeting of radiation therapy during a laparoscopic abdominal, pelvic, or retroperitoneal procedure. The documentation should support the need for radiation therapy and the use of interstitial devices for guidance.
The surgeon places fiducial markers or a dosimeter during a laparoscopic procedure to guide radiation therapy and ensure accurate targeting of the treatment area.
In simple words: During a laparoscopic procedure in the abdomen, pelvis, or retroperitoneal area, the surgeon places small markers or devices to guide radiation therapy or measure radiation dose. This is done in addition to the main laparoscopic procedure.
Laparoscopy, surgical; with placement of interstitial device(s) for radiation therapy guidance (eg, fiducial markers, dosimeter), intra-abdominal, intrapelvic, and/or retroperitoneum, including imaging guidance, if performed, single or multiple (List separately in addition to code for primary procedure) (Use 49327 in conjunction with laparoscopic abdominal, pelvic, or retroperitoneal procedure[s] performed concurrently) (For placement of interstitial device[s] for intra-abdominal, intrapelvic, and/or retroperitoneal radiation therapy guidance concurrent with open procedure, use 49412) (For percutaneous placement of interstitial device[s] for intra-abdominal, intrapelvic, and/or retroperitoneal radiation therapy guidance, use 49411)
Example 1: A patient undergoes a laparoscopic colectomy for colon cancer. During the same procedure, the surgeon places fiducial markers around the tumor bed to guide post-operative radiation therapy., A patient with a pelvic tumor undergoes laparoscopic tumor debulking.Fiducial markers are placed laparoscopically to assist with targeted radiation therapy following the surgery., During a laparoscopic removal of an abdominal tumor, the surgeon inserts a dosimeter to measure the radiation dose delivered to the surrounding tissues during intraoperative radiation therapy.
Documentation should include the primary laparoscopic procedure performed, the type and number of interstitial devices placed (fiducial markers or dosimeter), the location of placement, and the use of imaging guidance if performed. The operative report should clearly indicate that the placement of the device(s) was for radiation therapy guidance.
** This code includes imaging guidance if performed. It includes placement of single or multiple devices.
- Revenue Code: P7B - ONCOLOGY - OTHER
- Specialties:Surgical Oncology, General Surgery, Gynecologic Oncology, Urology
- Place of Service:Ambulatory Surgical Center, Inpatient Hospital, Outpatient Hospital