Summary & Overview
CPT 55920: Placement of Needles/Catheters to Facilitate Brachytherapy
CPT code 55920 covers placement of needles or catheters into cancerous pelvic organs or genitalia to facilitate brachytherapy, a form of internal radiotherapy that delivers radiation directly to a tumor. The code captures an important preparatory interventional procedure used across oncology and radiation oncology services to enable precise, organ‑preserving cancer treatment. Nationally, use of brachytherapy techniques influences care pathways, facility resource needs, and multidisciplinary coordination between surgical and radiation teams.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The analysis addresses coverage and billing considerations relevant to these major national payers and Medicare, providing context for how this preparatory procedure is recognized across public and commercial plans.
Readers will learn the clinical context and typical settings for CPT code 55920, benchmarking topics such as common sites of service and interventional role in brachytherapy workflows, and policy-relevant considerations that affect coding and payment for implant facilitation procedures. The summary highlights what facilities and clinicians should consider when documenting the procedural intent and service setting. Data not available in the input is noted where specific payer policies, taxonomies, or diagnosis mappings would normally be summarized.
Billing Code Overview
CPT code 55920 describes placement of needles or catheters into a cancerous pelvic organ or genitalia to facilitate brachytherapy (internal radiotherapy). This procedure is performed to allow subsequent placement of radioactive seeds or sources that deliver targeted radiation directly to a tumor.
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Service type: Interventional procedure to facilitate brachytherapy
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Typical site of service: Hospital operating room, ambulatory surgery center, or procedure suite with radiation oncology and surgical support
Clinical & Coding Specifications
Clinical Context
A 64-year-old woman with biopsy-proven Stage IB2 cervical carcinoma is scheduled for interstitial brachytherapy to deliver high-dose radiation directly to the tumor bed following external beam radiotherapy. On the day of the procedure the patient presents to the ambulatory oncology procedural suite after preoperative evaluation, informed consent, and anesthesia assessment. Under monitored anesthesia care or general anesthesia, the radiation oncologist and gynecologic oncologist or brachytherapy team place transperineal needles and/or intracavitary catheters into the cervix, parametrium, and vaginal fornices using image guidance (ultrasound, CT, or fluoroscopy) to define target geometry and protect adjacent organs. The procedure facilitates subsequent placement of radioactive sources (seeds or high-dose-rate afterloading catheters) for internal radiotherapy.
Typical site of service is an outpatient ambulatory surgery center or hospital operating room with specialized brachytherapy and imaging capabilities. The clinical workflow includes preprocedure planning (simulation and imaging), intraoperative placement of needles/catheters and verification imaging, documentation of placement and number of applicators, and coordination with radiation physics for source loading and treatment planning. Postprocedure monitoring includes pain control, hemostasis assessment, and discharge instructions with follow-up for radioactive source delivery and treatment planning.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component |