2025 CPT code 79445
(Active) Effective Date: N/A Radiology - Nuclear Medicine Feed
Radiopharmaceutical therapy administered intra-arterially.
Modifiers can be applied. Modifier 26 is used for the professional component (interpretation). Modifier TC is used for the technical component (administration). Modifier 59 is used to distinguish it from other procedures performed on the same day.
Medical necessity must be established for this procedure, demonstrating that it is the appropriate treatment for the patient's condition. The documentation should include the diagnosis, the rationale for choosing this therapy over other available options, and the expected benefits.
In simple words: This procedure involves injecting a liquid with radioactive particles into the artery that feeds a tumor to block its blood supply and shrink it. This targeted radiation minimizes damage to healthy tissue, and the radioactivity fades over time. The cost of the radioactive material itself may be billed separately.
This code represents the administration of a radiopharmaceutical agent directly into an artery for therapeutic purposes. It involves delivering radioactive particles through the bloodstream to treat tumors, primarily in the liver. The procedure includes supervision, handling, and loading of the radioactive source. It does not include the radiopharmaceutical itself, which is billed separately. This code is typically used when an interventional radiologist is the sole treating physician.
Example 1: A patient with a liver tumor unsuitable for surgical removal undergoes radioembolization. The interventional radiologist inserts a catheter into an artery and injects Yttrium-90 microspheres into the hepatic artery, delivering a high dose of radiation to the tumor., A patient with a primary liver cancer not amenable to resection or ablation is treated with selective internal radiation therapy (SIRT) using Y-90 microspheres administered intra-arterially by an interventional radiologist. , A patient with metastatic colorectal cancer to the liver receives radioembolization with Y-90 resin microspheres. An interventional radiologist performs the procedure, mapping the blood supply to the liver and delivering the microspheres to target the tumors selectively.
Documentation should include details of the procedure, including the type and dose of radiopharmaceutical used, the location of the injection site, and confirmation of proper placement. The report should also document the pre-procedure imaging and mapping, as well as any complications encountered. Prior authorization or pre-determination documentation from the payer may be required. If a radiation oncologist is involved as the authorized user (AU) instead of the interventional radiologist, the radiation oncologist would use a different code (77778).
- Revenue Code: P6D - Minor procedures - other (non-Medicare fee schedule)
- Specialties:Interventional Radiology, Nuclear Medicine, Radiation Oncology
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center