Summary & Overview
CPT 97007: Scalp Cooling Device Measurement, Fitting, Supply, and Education
CPT code 97007 captures the measurement, fitting, supply, and patient education for a scalp cooling device used across a chemotherapy treatment period. Nationally, this code matters as scalp cooling gains attention for its role in chemotherapy-induced alopecia prevention and for the administrative implications of billing a single-per-treatment-period service that includes both device provision and instructional counseling. The code is relevant to public and private payers managing coverage for supportive oncology services and durable medical equipment.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of what the code represents, typical clinical settings and workflows, and the types of benchmarks and policy considerations commonly examined for this service. The publication outlines common billing practice notes, payer coverage patterns, and where stakeholders often look for authorization and documentation guidance. It also provides clinical context on how the service integrates into chemotherapy care pathways and what claims administrators typically review when adjudicating a 97007 charge.
Data not available in the input for specific modifiers, associated taxonomies, ICD-10 diagnoses, related codes, and payer-specific coverage policies.
Billing Code Overview
CPT code 97007 describes the measurement, fitting, and provision of a scalp cooling device, including patient education about how scalp cooling works and what to expect. This procedure is reported once for an entire chemotherapy treatment period and reflects a bundled service encompassing device supply and instructional counseling.
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Service type: Medical device provision with patient education and fitting
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Typical site of service: Outpatient oncology clinic or infusion center
Clinical & Coding Specifications
Clinical Context
A 52-year-old woman with stage II invasive ductal carcinoma is scheduled to receive a multi-cycle cytotoxic chemotherapy regimen at an outpatient infusion center. Prior to her first chemotherapy session, a licensed clinician measures the patient’s head circumference, fits a medical-grade scalp cooling cap, instructs the patient on how the device works, discusses common sensations and expected timing for cap wear (pre‑ and post‑infusion cooling periods), and documents patient education and device supply. The cooling cap is supplied and fitted once for the entire chemotherapy course; subsequent infusions use the same device unless replacement is needed. Typical workflow includes pre-chemotherapy nursing assessment, cap fitting and education by a trained clinician (oncology nurse or certified medical fitter), documentation of the fit and instructions in the medical record, coordination with infusion scheduling for required pre-cool and post-cool times, and billing of 97007 once per chemotherapy treatment period.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
25 | Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure | Use when an E/M visit is performed on the same day as cap fitting and is separately identifiable from the scalp cooling service |