Description of CPT code 96547 and 96548
Procedure codes 96547, 96548 describe hyperthermic intraperitoneal chemotherapy (HIPEC) procedure that includes intraoperative perfusion of a heated chemotherapy agent into the abdominal cavity through catheters. The HIPEC procedure is distinct from the primary procedure and may include chemotherapy agent selection, confirmation of perfusion equipment settings for chemotherapy agent delivery, additional incision(s) for catheter and temperature probe placement, perfusion supervision and manual agitation of the heated chemotherapy agent in the abdominal cavity during chemotherapy agent dwell time, irrigation of the chemotherapy agent, closure of wounds related to HIPEC, and documentation of the chemotherapy agent and HIPEC procedure in the medical record.
CPT codes 96547, 96548 are add-on codes and do not include the typical preoperative, intraoperative, and postoperative work related to the primary procedure. Code 96547 is reported for the first 60 minutes of the HIPEC procedure and 96548 is reported for each additional 30 minutes.
96547 Intraoperative hyperthermic intraperitoneal chemotherapy (HIPEC) procedure, including separate incision(s) and closure, when performed; first 60 minutes (List separately in addition to code for primary procedure)
96548 each additional 30 minutes (List separately in addition to code for primary procedure)
When to use Use of Add-on Codes 96547 and 96548
The role of intraoperative HIPEC has become well accepted for the treatment of peritoneal, mesenteric, and retroperitoneal disease in properly selected patients with, for example, appendiceal neoplasms, colorectal cancer, and peritoneal mesothelioma. Therefore, HIPEC has sufficient utilization and literature to warrant Category I code assignment instead of utilizing an unlisted code or modifier 22, Increased Procedural Services, appended to a primary procedure code.
New add-on codes 96547 and 96548 have been established to report the total time of the HIPEC procedure. The introductory guidelines preceding codes 96547 and 96548 define the face-to-face and non-face-to-face work that is and is not included in the procedure when performed. Notably, these codes do not include the typical preoperative, intraoperative, and postoperative work related to the primary procedure(s) represented by the listed codes in the parenthetical note following code 96548. Only the total time related to the HIPEC procedure as defined in the guidelines may be reported with codes 96547 and 96548.
Codes 96547 and 96548 are time-based codes and, therefore, may not be reported until the midpoint of the time increment in the code descriptors has been reached. Specifically, code 96547 may not be reported until at least 31 minutes have been reached, unless the procedure is discontinued (eg, the patient becomes unstable or has an allergic reaction to the chemotherapy agent), in which case modifier 53, Discontinued Procedure, should be appended to code 96547. In addition, code 96548 may only be reported after an additional 16 minutes of the HIPEC procedure above the initial 60 minutes reported with code 96547 is attained (ie, 76 minutes of total time).
Reference: CPT assistant December edition
