Summary & Overview
HCPCS C2645: Brachytherapy Planar Source, Palladium-103 per mm2
HCPCS Level II code C2645 identifies a brachytherapy planar source composed of palladium-103 billed on a per-square-millimeter basis. This code is used to report the supply of radioactive planar sources employed in localized radiation therapy, most commonly within radiation oncology procedures. Accurate coding of brachytherapy sources is critical for device accounting, reimbursement mapping, and clinical documentation of implant-based radiation therapy.
Key payers covered in this national overview include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication outlines payer coverage considerations, common reimbursement and billing practices, and clinical context for palladium-103 planar sources.
Readers will learn: the clinical role of palladium-103 planar sources in brachytherapy; how the code is used to represent the device supply; the typical sites of service where these sources are utilized; and what to expect in payer coverage scope and policy areas. Data not available in the input will be noted where applicable. This summary provides a concise reference for billing professionals, radiation oncology administrators, and policy analysts seeking a national-level understanding of HCPCS Level II code C2645.
Billing Code Overview
HCPCS Level II code C2645 describes a brachytherapy planar source using palladium-103, billed per square millimeter. This represents the physical radiation source used in brachytherapy procedures where small planar sheets or seeds of palladium-103 are placed to deliver localized radiation doses to target tissue.
Service type: Brachytherapy source supply
Typical site of service: Radiation oncology settings or procedural suites where brachytherapy implants are prepared and placed, including hospital outpatient departments and ambulatory surgery centers.
Clinical & Coding Specifications
Clinical Context
A 68-year-old male with clinically localized prostate cancer undergoes permanent seed brachytherapy using palladium-103 sources. The radiation oncology team orders C2645 billed per square millimeter for the planar palladium-103 sources used to create low-dose-rate implants placed intraoperatively under ultrasound guidance. Typical workflow: pre-procedure consultation and staging (history, prostate MRI, prostate biopsy pathology), treatment planning by a medical physicist with dosimetry and source ordering, operating-room or procedure-suite transperineal implantation using transrectal ultrasound guidance, intraoperative real-time dosimetry adjustments, and post-implant dosimetric verification with CT within 30 days. Typical site of service is an outpatient hospital-based procedure room, ambulatory surgery center, or radiation oncology department procedural suite. Common clinical indications include localized prostate adenocarcinoma and select small-volume recurrent pelvic soft-tissue malignancies where palladium-103 LDR planar sources are clinically appropriate.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier | Standard use when no additional modifier applies |
22 |