Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); each additional cranial lesion, simple (List separately in addition to code for primary procedure)
CPT4 code
Name of the Procedure:
Stereotactic Radiosurgery (SRS); each additional cranial lesion, simple
Summary
Stereotactic radiosurgery (SRS) is a non-invasive procedure that uses focused beams of radiation to treat abnormalities, tumors, or lesions in the brain. This specific code refers to the treatment of each additional cranial lesion, performed in addition to the primary procedure.
Purpose
Stereotactic radiosurgery is used to treat brain tumors, arteriovenous malformations (AVMs), and other brain disorders non-invasively. The goal is to destroy or shrink the lesion without harming surrounding healthy tissue.
Indications
- Brain metastases
- Primary brain tumors
- Arteriovenous malformations (AVMs)
- Acoustic neuromas
- Trigeminal neuralgia
- Recurrent or residual brain lesions
Patient factors:
- Lesions that show no improvement with conventional treatments
- Patients who are not suitable candidates for traditional surgery
Preparation
- Fasting may be required for a certain period before the procedure.
- Medication adjustments may be necessary, particularly with anticoagulants.
- MRI or CT scans are typically performed to map the lesion(s).
Procedure Description
- The patient is fitted with a specialized head frame or mask to keep the head still.
- Diagnostic images (MRI or CT) are taken to precisely locate the lesion(s).
- A treatment plan is created using specialized software.
- The patient is positioned on the treatment table, and radiation beams are directed precisely at the lesion(s).
- Each additional cranial lesion is targeted according to the pre-defined plan.
Tools/Technology:
- Linear accelerators (LINAC)
- Gamma Knife
- Particle beams (protons)
Anesthesia:
- Local anesthetic for head frame application
- Sedation if necessary
Duration
The procedure for each additional cranial lesion typically takes between 30 minutes to an hour, depending on the complexity.
Setting
Performed in a specialized treatment center, outpatient clinic, or hospital with radiosurgery capabilities.
Personnel
- Radiation oncologist
- Neurosurgeon
- Medical physicist
- Radiologic technologist
- Nursing staff
Risks and Complications
- Fatigue
- Headache
- Scalp or skin irritation
- Temporary swelling of the brain
- Rare risks include neurological issues, radiation necrosis, or new tumor growth
Benefits
- Non-invasive procedure
- Precise targeting of lesions, sparing healthy tissue
- Can be an alternative for patients who cannot undergo traditional surgery
- Shorter recovery time compared to surgical options
Recovery
- Patients can typically go home the same day.
- Mild headache and fatigue may persist for a few days.
- Follow-up imaging studies to monitor treatment effects.
- Possible restricted activity depending on the patient's condition and response.
Alternatives
- Conventional brain surgery
- Whole-brain radiation therapy
- Chemotherapy
- Observation (for certain lesions)
Pros and cons of alternatives:
- Traditional surgery offers immediate removal but with higher risks and longer recovery.
- Whole-brain radiation therapy treats widespread metastases but can have more side effects.
Patient Experience
During the procedure:
- Minimal discomfort due to the head frame or mask
- Little to no pain during the actual radiosurgery
After the procedure:
- Possible mild headache or fatigue
- Specific pain management strategies will be discussed and provided
- Overall, the experience is generally well-tolerated with a quick return to normal activities.