SIRSPHERES 2006 FINAL CODING SHEET 3-15-06

CODING SHEET FOR PHYSICIAN & HOSPITAL OUTPATIENT SERVICESMARCH 2006 March 2006 Post-Treatment Follow Up Lab Visits (see page 8) PET Scan (see page 8) Post-Procedure Observation (See page 7) Liver Imaging (SPECT) SIR-Spheres Microspheres Administration Supervision, Handling & Loading Place arterial catheter Interstitial radiation source application Patient Referral (see page 10) Cancer Center Medical Oncologists Interventional Radiology (see page 10) Consult Screening Lab Tests See page 13 (Appendix) PATIENT NOT ELIGIBLE Alternative Treatment 20% or Greater Shunting? Less than 20% Shunting? Nuclear Medicine (see page 3) Tc99 MAA Scan Diagnostic Radiology (see pages 1 - 3) CT Abdomen MRA Abdomen 3-D Post-Processing Baseline PET Angiography Phase 1: SIR-Spheres ScreeningPatient Eligible (See page 4 )Schedule Treatment SIR-Spheres Order 7-10 days prior to treatment DAY OF TREATMENT (See pages 6 7) Nuclear Medicine/Radiation Oncology(see pages 4 5) Clinical Treatment Planning Medical Radiation Dosimetry TREATMENT PLAN DOSE CALCULATION (pages 4 - 5) Phase 2: SIR-Spheres TreatmentSIR-SPHERES MICROSPHERES TREATMENT FLOW CHARTB ilirubin above PATIENT NOT ELIGIBLE SELECTIVE INTERNAL RADIATION THERAPY (SIRT) SIR-SPHERES TREATMENT CODING SIR-Spheres microspheres is indicated for the treatment of unresectable metastatic liver tumors from primary colorectal c

SELECTIVE INTERNAL RADIATION THERAPY (SIRT) SIR-SPHERES TREATMENT CODING SIR-Spheres microspheres is indicated for the treatment of …

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