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Ablation therapy for reduction or eradication of 1 or more pulmonary tumor(s) including pleura or chest wall when involved by tumor extension, percutaneous, including imaging guidance when performed, unilateral; cryoablation

CPT4 code

Name of the Procedure:

Ablation therapy for reduction or eradication of 1 or more pulmonary tumor(s) including pleura or chest wall when involved by tumor extension, percutaneous, including imaging guidance when performed, unilateral; cryoablation.

Summary

Cryoablation is a minimally invasive procedure that uses extreme cold to destroy cancerous tumors in the lungs, pleura, or chest wall. The treatment involves inserting a needle-like probe through the skin to target the tumors, guided by imaging techniques like CT scans.

Purpose

Cryoablation aims to reduce or completely eradicate pulmonary tumors, which include tumors that have spread to the pleura or chest wall. The primary goal is to control or eliminate cancerous growth with minimal harm to surrounding tissues.

Indications

  • Diagnosed with one or more pulmonary tumors.
  • Tumor involvement of pleura or chest wall extension.
  • Patients who are not ideal candidates for surgical resection.
  • Desire for a less invasive treatment option compared to traditional surgery.

Preparation

  • Fasting for a specified period before the procedure.
  • Adjustments to current medications as advised by the physician.
  • Pre-procedure imaging tests like CT or PET scans to map the tumor.

Procedure Description

  1. The patient is positioned and prepped.
  2. Anesthesia or sedation is administered.
  3. Using imaging guidance, a cryoprobe is inserted through the skin to the targeted tumor.
  4. The cryoprobe releases extremely cold gases to freeze and destroy the cancerous tissue.
  5. The probe may be repositioned and the process repeated for multiple tumors.
  6. The probe is removed, and a dressing is applied to the insertion site.

Duration

The procedure typically takes 1 to 3 hours, depending on the number and size of the tumors.

Setting

Cryoablation is usually performed in a hospital or an outpatient surgical center.

Personnel

  • Interventional radiologist or thoracic surgeon.
  • Anesthesiologist or nurse anesthetist.
  • Radiology technicians.
  • Nursing staff.

Risks and Complications

  • Bleeding at the insertion site.
  • Infection.
  • Injury to nearby organs or tissues.
  • Pneumothorax (collapsed lung).
  • Rarely, adverse reaction to sedation or anesthesia.

Benefits

  • Minimally invasive with shorter recovery time.
  • Effective in controlling or eliminating tumors.
  • Less damage to surrounding healthy lung tissue.
  • Can be repeated if necessary.

Recovery

  • Monitoring for a few hours post-procedure.
  • Pain management with prescribed medications.
  • Avoiding strenuous activities for several days.
  • Follow-up imaging and appointments to monitor the effectiveness of the treatment.

Alternatives

  • Surgical resection of the tumor.
  • Radiation therapy.
  • Chemotherapy.
  • Pros: Surgery may completely remove the tumor; radiation and chemotherapy can treat widespread cancer.
  • Cons: Surgery is more invasive with longer recovery; radiation and chemotherapy have systemic side effects.

Patient Experience

Patients may feel an initial cold sensation followed by numbness in the treated area during the procedure. Post-procedure, mild discomfort or pain at the insertion site is common, but can be managed with pain relief medications. Regular follow-up is essential to ensure recovery and monitor for any complications.

Medical Policies and Guidelines for Ablation therapy for reduction or eradication of 1 or more pulmonary tumor(s) including pleura or chest wall when involved by tumor extension, percutaneous, including imaging guidance when performed, unilateral; cryoablation

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