SpaceOAR Gets a Code
CPT® 2018 introduces a new Category I code, 55874 Transperineal placement of biodegradable material, peri-prostatic, single or multiple injection(s), including image guidance, when performed to describe the supply and placement of a temporary, biodegradeable implant, marketed as the SpaceOAR System, that is used to reduce rectal injury in men receiving prostate cancer radiation therapy (RT). Code 55874 replaces category III code 0438T.
The AMA’s CPT Changes 2017: An Insider’s Guide explains:
Although higher doses of radiation therapy may be used for treatment of prostate tissue to improve biochemical disease-free survival, the adverse effect is that an exposed rectum also receives radiation, increasing the risk of toxicity to the rectum and gastrointestinal tract.
The SpaceOAR implant acts as a spacer, pushing the rectum away from prostate; thereby, reducing the amount of incidental radiation the rectum is exposed to during RT for prostate cancer.
The implant is placed via needle, and placement includes imaging guidance. Per CPT® guidelines, do not separately report 76942 Ultrasonic guidance for needle placement [e.g., biopsy, aspiration, injection, localization device], imaging supervision and interpretation with 55974.