AHA Coding Clinic® for HCPCS - 2013 Issue 1; ASK the EDITOR

Microwave ablation

The issue presented is the request to report CPT code 47370, Laparoscopy, surgical, ablation of 1 or more liver tumor(s); radiofrequency, when instead of radiofrequency, microwave is utilized for ablation of the tumors. The medical history of liver tumor ablation is currently more than 10 years old and the initial technologies that were available in the United States were limited to radiofrequency energy. Current devices use an energy source in the microwave range as an alternative approach. While this may appear to be a completely different procedure, there are not differences in the technical procedures, only in the energy source and the way that heat is generated to treat the medical disorder. The transition to using microwave energy from radiofrequency occurred as the RF technologies suffered from a “heat sink” when tumors located near vessels were treated and the tumor would remain viable because the temperature of the tissue could not reach ideal treatment levels. Microwave ablation generates an energy field that radiates away from the probe and is not negatively impacted by the proximity of vascular structures. As the procedures are the same and the results are comparable it could be asserted that microwave ablation and radiofrequency ablation are interchangeable procedures and should be coded using one CPT code. ...

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