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Computed tomography guidance for needle placement (eg, biopsy, aspiration, injection, localization device), radiological supervision and interpretation

CPT4 code

Name of the Procedure:

Computed Tomography (CT) Guidance for Needle Placement
Common Name: CT-Guided Biopsy, CT-Guided Aspiration

Summary

CT-Guided Needle Placement is a minimally invasive procedure that uses computed tomography imaging to guide the placement of a needle to a specific area of the body. This procedure is commonly used to perform biopsies, drain fluid, inject medications, or place localization devices.

Purpose

CT-Guided Needle Placement is used to diagnose or treat medical conditions by accurately targeting specific areas within the body. The primary goals of the procedure are to obtain tissue samples, drain cysts or abscesses, deliver therapeutic agents, or mark tissues for surgical planning.

Indications

  • Suspicious masses or tumors needing biopsy
  • Abscesses or fluid collections requiring drainage
  • Injection of medications directly into a lesion or joint
  • Marking of lesions for surgical removal

Preparation

  • Patients may be instructed to fast for several hours before the procedure.
  • Adjustments to medications, particularly blood thinners, may be needed.
  • Pre-procedure imaging tests, such as CT scans or MRIs, may be required for planning.

Procedure Description

  1. Patient lies on the CT scanner table.
  2. The area of interest is scanned to locate the target.
  3. The skin is cleaned, and local anesthesia is applied.
  4. Under CT guidance, a needle is inserted through the skin to the targeted area.
  5. Tissue samples are taken, fluid is aspirated, or medication is injected.
  6. The needle is carefully withdrawn, and the entry site is bandaged.

Tools and Equipment: CT scanner, needles, syringes, local anesthesia.

Anesthesia: Local anesthesia is typically used to numb the area.

Duration

The procedure usually takes about 30 to 60 minutes, depending on the complexity.

Setting

The procedure is performed in a hospital radiology department or an outpatient imaging center.

Personnel

  • Radiologist or Interventional Radiologist
  • Radiologic Technologist
  • Nurse

Risks and Complications

  • Bleeding or hematoma formation
  • Infection at the needle insertion site
  • Damage to surrounding tissues or organs
  • Pneumothorax (collapsed lung), particularly in lung biopsies

Benefits

  • Minimally invasive with a quicker recovery time than surgery
  • Accurate targeting of lesions for diagnostic and therapeutic purposes
  • Provides crucial information for diagnosis and treatment planning

Recovery

  • Patients are monitored for a short period post-procedure.
  • Instructions may include rest and avoiding strenuous activity for 24 hours.
  • Follow-up appointments may be scheduled to review biopsy results or assess recovery.

Alternatives

  • Ultrasound-guided needle placement
  • Surgical biopsy
  • Imaging follow-ups without immediate tissue sampling

Pros of Alternatives: Less invasive options, such as ultrasound guidance, may be suitable for certain cases. Surgical biopsy may be more definitive in some scenarios but involves more risk and recovery time.

Patient Experience

  • Patients may feel slight pressure or discomfort during needle insertion.
  • Pain management typically involves local anesthesia, with minimal pain afterward.
  • A mild soreness at the insertion site may persist for a day or two.

Medical Policies and Guidelines for Computed tomography guidance for needle placement (eg, biopsy, aspiration, injection, localization device), radiological supervision and interpretation

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