Radiofrequency Ablation - Liver

Radiofrequency Ablation

Radiofrequency ablation is a technology used in radiology for the treatment of primary and metastatic tumors.

The procedure involves placement of a needle into the tumor with adherence to impedance protocols to determine how long to transmit Radiofrequency energy into the tumor to destroy it completely.

CPT 47382 - Ablation, 1 or more liver tumors, percutaneous, radiofrequency 

For imaging guidance and monitoring, see 76940, 77013, 77022 

(76940 - Ultrasound guidance for, and monitoring of, parenchymal tissue ablation

77013 - Computed tomography guidance for, and monitoring of, parenchymal tissue ablation

77022 - Magnetic resonance guidance for, and monitoring of, parenchymal tissue ablation) 

Procedure Description:

The patient is appropriately prepped and anesthetized, the physician uses imaging guidance, such as CT, MRI, or ultrasound, to locate the site of the tumor. he places a radiofrequency needle electrode into the tumor in the liver. he applies electrical energy that causes the tissue to heat to a high temperature. This heat leads to destruction of the tumor. he may treat one or more tumors at the session. Scar tissues take over the tumor cells and lead to repair. After completing the destruction process, the physician withdraws the needle from the liver.

If the physician uses a laparoscopic approach, then use CPT 47370 

CPT 47370 - Laparoscopy, surgical, ablation of 1 or more liver tumors, radiofrequency 

Imaging guidance, use CPT 76940 

Procedure Description:

The patient is prepped and anesthetized, the physician makes a small incision in the umbilicus or right upper abdomen and inserts a laparoscope. then the physician examines the structures surrounding the liver. he uses this opening to insufflate or blow gas into the abdomen. This insufflation lifts the abdominal wall away from the organs and improves visualization of the site of interest. he makes additional small incisions and inserts a camera and instruments to perform the procedure. Once he enters the abdomen and has good visualization of the cavity, the physician identifies the tumor site in the liver and performs a biopsy. he introduces a radiofrequency ablation probe into the tumor and applies electrical energy that causes the tissue to heat to a high temperature. This heat leads to destruction of the tumor. Then he removes the probe, checks for bleeding, and closes the incisions with sutures in layers.

If the physician performs Open liver RF ablation - Use CPT 47380

CPT 47380 - Ablation, open, of 1 or more liver tumors, radiofrequency 

Imaging guidance, use 76940

Procedure Description:

The patient is prepped and anesthetized, the physician makes an incision in the upper abdomen and dissects the structures surrounding the liver to locate the exact site of the tumor. He performs a biopsy of the affected tissues and sends them to pathology for further analysis. The physician introduces a radiofrequency ablation probe into the tumor and applies electrical energy that causes the tissue to heat to a high temperature. This heat leads to destruction of the tumor. he removes the probe and checks for bleeding and closes the incision in the abdomen with sutures in layers.

If the physician performs liver cryoablation Then use CPT  47381 or 47371 based on the procedure.