D91897Z – High Dose Rate (HDR) Brachytherapy of Hard Palate using Cesium 137 (Cs-137)
Coding Notes
Active
Billable, valid for HIPAA-covered transactions
PCS Table
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Section
D
Radiation Therapy
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Body System
9
Ear, Nose, Mouth and Throat
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Modality
1
Brachytherapy
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| Treatment Site | Modality Qualifier | Isotope | Qualifier |
|
0
Ear
1
Nose
3
Hypopharynx
4
Mouth
5
Tongue
6
Salivary Glands
7
Sinuses
8
Hard Palate
9
Soft Palate
B
Larynx
D
Nasopharynx
F
Oropharynx
|
9
High Dose Rate (HDR)
|
7
Cesium 137 (Cs-137)
8
Iridium 192 (Ir-192)
9
Iodine 125 (I-125)
B
Palladium 103 (Pd-103)
C
Californium 252 (Cf-252)
Y
Other Isotope
|
Z
None
|
|
0
Ear
1
Nose
3
Hypopharynx
4
Mouth
5
Tongue
6
Salivary Glands
7
Sinuses
8
Hard Palate
9
Soft Palate
B
Larynx
D
Nasopharynx
F
Oropharynx
|
B
Low Dose Rate (LDR)
|
6
Cesium 131 (Cs-131)
7
Cesium 137 (Cs-137)
8
Iridium 192 (Ir-192)
9
Iodine 125 (I-125)
C
Californium 252 (Cf-252)
Y
Other Isotope
|
Z
None
|
|
0
Ear
1
Nose
3
Hypopharynx
4
Mouth
5
Tongue
6
Salivary Glands
7
Sinuses
8
Hard Palate
9
Soft Palate
B
Larynx
D
Nasopharynx
F
Oropharynx
|
B
Low Dose Rate (LDR)
|
B
Palladium 103 (Pd-103)
|
1
Unidirectional Source
Z
None
|
GEM Conversion to ICD-9 PCS
Fs: 10000
–
Radioisotopic teleradiotherapy