ICD-10-PCS Billable Code

D926DZZ

Stereotactic Radiosurgery Salivary Glands to None with None, Stereotactic Other Photon Radiosurgery Approach

Procedural Specifications

Clinical Axis Detail Definition
SectionD Radiation Therapy
Body System9 Ear, Nose, Mouth and Throat
Operation2 Stereotactic Radiosurgery
Body Part6 Salivary Glands
ApproachD Stereotactic Other Photon Radiosurgery
DeviceZ None
QualifierZ None

Procedure Overview

Stereotactic radiosurgery for the ear, nose, mouth, and throat delivers a very precisely focused, high dose of radiation to a small, well-defined target, typically completed in a single session or a small number of sessions rather than the many weeks of a standard course. It is used for select tumors or vascular lesions in this region where extreme precision can spare nearby critical structures such as the optic nerves, brainstem, or major blood vessels.

Treatment relies on advanced imaging and computer-guided targeting to shape the radiation beam tightly around the lesion. Patients generally tolerate the procedure well since it is noninvasive, though careful pre-treatment planning and immobilization are essential to keep the beam accurately aligned with the target.

Anatomy & Axis Detail

Salivary Glands

The salivary glands include the parotid, submandibular, and sublingual glands, structures responsible for producing saliva that supports digestion and oral mucosal health, and they can be the site of primary tumors ranging from benign pleomorphic adenomas to malignant mucoepidermoid or adenoid cystic carcinomas. Stereotactic radiosurgery is typically considered for small residual or recurrent tumors, or for lesions near the facial nerve where surgical margins are difficult to achieve, since a highly conformal dose can be delivered in one or few sessions while limiting exposure to adjacent glandular tissue and the facial nerve trunk. Given the parotid's proximity to the ear canal and mandible, precise imaging and immobilization are essential. Documentation should specify which gland was treated, as this affects both technique and expected xerostomia risk.

Modality Qualifier: Stereotactic Other Photon Radiosurgery

Stereotactic Other Photon Radiosurgery captures highly focused, single- or few-fraction photon radiosurgery delivered by systems other than dedicated gamma-emitting units, such as linear-accelerator-based platforms, using precise stereotactic targeting to ablate small, well-defined lesions. It is distinguished from Stereotactic Gamma Beam Radiosurgery, which specifically uses cobalt-60 gamma sources, and from Stereotactic Particulate Radiosurgery, which relies on charged particle beams rather than photons.

Coding & Documentation

Documentation must describe the use of stereotactic guidance and confirm the highly focused, image-based targeting characteristic of radiosurgery rather than a conventional fractionated beam schedule. Coders should look for terms describing frame-based or frameless stereotactic systems and the specific ENT structure targeted.

Commonly Confused With

Beam RadiationThis is most often confused with standard Beam Radiation, since both use an external source; the distinguishing feature of radiosurgery is the stereotactic, image-guided precision and typically abbreviated number of treatment sessions.
BrachytherapyIt differs from Brachytherapy in that no radioactive source is placed inside or against the tissue - the radiation is delivered entirely from outside the body.