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2025 CPT code 55862

Exposure of the prostate, any approach, for insertion of radioactive substance; with lymph node biopsy(s) (limited pelvic lymphadenectomy).

Follow CPT guidelines for surgical procedures and brachytherapy.Ensure accurate documentation to support medical necessity and proper code selection.

Modifiers may be applicable depending on the circumstances of the procedure (e.g., 59 for distinct procedural service, 80 for assistant surgeon).

Medical necessity for this procedure is established by the presence of prostate cancer suitable for brachytherapy, considering the patient's overall health, age, and other clinical factors.The limited pelvic lymphadenectomy is medically necessary for staging and treatment planning.

The surgeon performs the perineal incision, accesses the prostate, performs the lymph node biopsy, places a needle at the tumor site, and closes the incision after seed implantation by another provider. The surgeon is responsible for prepping and anesthetizing the patient, inserting the rectal sheath and urethral catheter, exploring and retracting the bladder, and managing post-operative care including irrigation and hemostasis.The oncologist or radiologist is responsible for the implantation of radioactive seeds using ultrasound guidance.

IMPORTANT:Select clinical brachytherapy radiation treatment codes from the range 7775077799. Report ultrasound, or other imaging guidance, separately.For transurethral removal of prostate, see 52601-52640. For transurethral destruction of prostate, see 53850-53852. For limited pelvic lymphadenectomy for staging [separate procedure], use 38562. For independent node dissection, see 38770-38780.

In simple words: The doctor makes a cut in the area between the scrotum and anus to expose the prostate gland.Radioactive seeds are then placed into the prostate to treat prostate cancer. The doctor also takes a sample of nearby lymph nodes to check for cancer spread.

This procedure involves surgical exposure of the prostate gland to facilitate the insertion of radioactive material for the treatment of prostate cancer.The procedure includes a perineal incision to access the prostate, placement of a tubular sheath in the rectum, and catheterization of the urethra for bladder drainage.Exploration and retraction of the bladder are performed to reach the prostate.A lymph node biopsy (limited pelvic lymphadenectomy) is conducted, and the specimens are sent for pathological analysis.A needle is placed at the tumor site, and another provider inserts radioactive seeds into the prostate under ultrasound guidance.Post-seed insertion, a drainage tube is placed in the wound, the area is irrigated, hemostasis is achieved, instruments are removed, and the incision is closed.

Example 1: A 65-year-old male patient is diagnosed with localized prostate cancer.The surgeon performs a perineal exposure of the prostate for the implantation of radioactive seeds by a radiation oncologist. A limited pelvic lymphadenectomy is performed during the procedure. , A 72-year-old male patient with locally advanced prostate cancer undergoes a perineal prostatectomy for exposure and radioactive seed implantation.The lymph node biopsy reveals metastasis to regional lymph nodes., A 70-year-old male patient with a high-risk prostate cancer undergoes a perineal exposure of the prostate for brachytherapy, with a simultaneous limited pelvic lymphadenectomy for staging purposes.

Preoperative assessment including patient history, physical examination, imaging studies (MRI, CT, ultrasound), pathology reports from biopsies, and informed consent. Intraoperative documentation including details of the incision, exploration, lymph node dissection, placement of radioactive seeds (number, location, type), and closure. Postoperative documentation including pathology reports, drain output, pain management, and any complications.

** The insertion of radioactive material is typically performed by a different provider (e.g., a radiation oncologist).Ultrasound guidance for seed placement should be reported separately.Specific radioactive seed type should be documented.

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