Summary & Overview
CPT 97008: Scalp Cooling Assistance During Chemotherapy
CPT code 97008 covers provider-assisted scalp cooling performed at the start of a chemotherapy session. This adjunctive oncology service involves preparing the patient’s hair, positioning the cooling cap, initiating the cooling system, and commencing the precooling period before chemotherapy infusion. The code is reported once per chemotherapy session and is relevant for facilities that offer hair-preservation techniques to mitigate chemotherapy-induced alopecia.
Key national payers relevant to CPT code 97008 include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Coverage and payment policies vary across carriers and plan types, and the service typically occurs in hospital outpatient infusion centers, ambulatory infusion centers, and oncology clinics.
Readers will find an overview of the clinical context for scalp cooling, the service setting, and how this code is used in billing workflows. The publication summarizes benchmark considerations, common documentation elements needed to support the service, and any recent policy developments or coding guidance that affect how CPT code 97008 is reported and reviewed by payers. Data not available in the input for specific payer policies, payment amounts, modifiers, and claim adjudication patterns is noted within the report.
Billing Code Overview
CPT code 97008 describes a provider-assisted scalp cooling service performed during a chemotherapy session. The service includes preparing the patient's hair, placing the cooling cap, initiating the cooling device, and starting the precooling period before chemotherapy begins. Report CPT code 97008 one time per chemotherapy session.
Service type: Supportive oncology/adjunctive service during chemotherapy infusion
Typical site of service: Hospital outpatient infusion center, ambulatory infusion center, or oncology clinic
Data not available in the input for payers, common modifiers, associated taxonomies, ICD-10 diagnoses, related codes, and service line.
Clinical & Coding Specifications
Clinical Context
A 54-year-old woman with stage II invasive ductal breast carcinoma is scheduled for her third outpatient infusion of an alopecia-inducing chemotherapy regimen (e.g., docetaxel and cyclophosphamide). Prior to each chemotherapy infusion, a trained oncology nurse prepares the patient for scalp cooling to reduce chemotherapy-related hair loss. The workflow begins with verifying the physician order for scalp cooling and confirming contraindications (e.g., known scalp metastases). The nurse explains the scalp cooling process, assists with shampooing or detangling as needed, measures the patient’s head circumference for proper cap sizing, and places the prechilling cap system. The nurse initiates the cooling device and monitors the precooling period required before infusion start. Once target scalp temperature is achieved and the cap is secured, chemotherapy infusion begins. The scalp cooling cap remains in place and the cooling continues during infusion and the post-infusion cooling period per device protocol. Billing uses 97008 reported once per chemotherapy session for the provider’s assistance with scalp cooling setup and initiation.
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 | When a separate E/M visit is provided the same day as scalp cooling setup and meets E/M documentation requirements. |