An Overview of Radiation Oncology Codes – Part 1

1. Visit our website: Click here Follow us: An Overview of Radiation Oncology Codes – Part 1 In radiation oncology, specific CPT code categories have been established to capture the various aspects of treatment, including delivery, planning, and specialized techniques. These codes not only facilitate billing and reimbursement processes but also contribute to accurate communication and tracking of procedures within the field. In this article, we will explore the radiation oncology codes for procedures like clinical treatment planning for radiation treatment; medical radiation physics, dosimetry, and treatment devices; stereotactic radiation treatment delivery; radiation treatment delivery; and neutron beam treatment delivery. We will discuss the rest of the radiation oncology codes in the second part of this article. Radiation Oncology Codes The CPT code range for radiation oncology is 77261-77799, which is maintained by American Medical Association. This code range is further divided into 10 subcategories, let’s explore the first five categories in detail: 1. Clinical Treatment Planning for Radiation Treatment (CPT Code Range 77261-77299) Clinical treatment planning is a crucial step in radiation oncology, where radiation therapy is carefully designed and tailored to target cancerous cells while sparing healthy tissues. The CPT code range 77261-77299 provides a standardized framework for documenting and billing Copyright © Medical Billers and Coders. All Rights Reserved Call now 888-357-3226 (Toll Free) info@medicalbillersandcoders.com 1

2. Visit our website: Click here Follow us: these procedures. Key CPT codes include 77261 (radiation treatment planning, simple); 77262 (radiation treatment planning, complex); 77263 (radiation treatment planning, IMRT); and 77280 (radiation treatment planning, proton). By accurately coding and documenting clinical treatment planning services, healthcare providers can ensure proper reimbursement and maintain the highest quality of care for their patients. 2. Medical Radiation Physics, Dosimetry, Treatment Devices, and Special Services for Radiation Treatment (CPT Code Range 77295-77370) The CPT code range 77295-77370 in radiation oncology encompasses a wide array of medical radiation physics, dosimetry, treatment devices, and special services. These codes reflect the critical contributions of medical radiation physicists, dosimetrists, and specialized equipment in ensuring the accurate and safe delivery of radiation therapy. Medical radiation physics involves the application of physics principles and techniques to radiation therapy. CPT codes in this range reflect the services provided by medical radiation physicists to ensure the safe and accurate delivery of radiation treatment. These codes include radiation treatment machine quality assurance, linear accelerator beam data acquisition, and verification of radiation treatment plans. Dosimetry refers to the measurement and calculation of radiation doses delivered to patients during radiation therapy. CPT codes in this category cover a range of dosimetric services, such as computerized dose calculations, verification of dose distribution, and calculation of treatment machine settings. These codes also encompass the creation and evaluation of treatment plans using advanced techniques such as intensity-modulated radiation therapy (IMRT) and stereotactic body radiation therapy (SBRT). Treatment devices are essential components used in radiation therapy to accurately deliver radiation to the target area while minimizing exposure to healthy tissues. CPT codes within this range represent the provision and maintenance of treatment devices. Examples include codes for the fabrication and application of immobilization devices, such as custom radiation therapy immobilization masks, as well as codes for the construction and placement of compensators and bolus material. Special services in radiation treatment encompass a variety of procedures and techniques that support the overall delivery and management of radiation therapy. CPT codes in this range cover services such as the fusion of imaging modalities (CT, MRI, PET) for treatment planning and target delineation, the performance of radiation physics consultations, and special dosimetry procedures. These codes recognize the additional Copyright © Medical Billers and Coders. All Rights Reserved Call now 888-357-3226 (Toll Free) info@medicalbillersandcoders.com 2

3. Visit our website: Click here Follow us: expertise and resources required for complex treatment scenarios and specialized patient needs. 3. Stereotactic Radiation Treatment Delivery (CPT Code Range 77371- 77387) Stereotactic radiation treatment delivery is a precise and advanced technique used in radiation oncology to deliver highly focused radiation to tumors with pinpoint accuracy. This treatment modality is particularly effective for small tumors and lesions in various parts of the body. The CPT code range 77371-77387 encompasses a series of codes that describe the different aspects and components of stereotactic radiation treatment delivery. The key CPT codes within this range are: 77371: Stereotactic radiation treatment delivery, single treatment area, single or multiple Fractions or sessions. 77372: Stereotactic radiation treatment delivery, single treatment area, four or more Fractions or sessions. 77373: Stereotactic radiation treatment delivery, multiple treatment areas, single or multiple Fractions or sessions. 77374: Stereotactic radiation treatment delivery, multiple treatment areas, four or more Fractions or sessions. 77385: Stereotactic body radiation therapy, treatment delivery, per fraction to one or more lesions, including image guidance, entire course not to exceed five fractions. 77386: Stereotactic body radiation therapy, treatment delivery, per fraction to one or more lesions, including image guidance, entire course not to exceed 10 fractions. 4. Radiation Treatment Delivery (CPT Code Range 77399-77417) Radiation treatment delivery is a critical component of radiation oncology, which involves the administration of therapeutic radiation to target and eradicate cancer cells. The process of delivering radiation therapy requires precision and adherence to established protocols to maximize the therapeutic effect while minimizing damage to healthy tissues. These codes reflect the complexity and techniques employed in delivering radiation therapy, ranging from simple to complex approaches. Proper coding and billing for radiation treatment delivery also require a thorough understanding of other related codes and procedures. For example, radiation treatment Copyright © Medical Billers and Coders. All Rights Reserved Call now 888-357-3226 (Toll Free) info@medicalbillersandcoders.com 3

4. Visit our website: Click here Follow us: planning (CPT codes 77261-77280) involves the development of a treatment plan, including target delineation and dose calculation. Image guidance (CPT codes 77014, and 77417) involves the use of imaging techniques like CT scans to guide the accurate placement of radiation therapy fields. Brachytherapy (CPT codes 77750-77762) refers to the implantation of radioactive sources within or near the tumor site for localized treatment. 5. Neutron Beam Treatment Delivery (CPT Code Range 77423-77425) Neutron beam therapy represents an advanced modality in radiation oncology, offering unique advantages in the treatment of certain cancers. The CPT code range 77423-77425 specifically addresses the various complexities involved in delivering neutron beam therapy. These codes help facilitate accurate documentation, coding, and billing for the services provided, ensuring appropriate reimbursement for the healthcare providers delivering this specialized treatment. Short descriptions of these codes are as follows: 77423: Neutron beam treatment delivery; simple 77424: Neutron beam treatment delivery; intermediate 77425: Neutron beam treatment delivery; complex Kindly refer to the second part of this article for the remaining radiation oncology codes representing procedures like radiation treatment management; proton beam radiation treatment delivery; radiation hyperthermia treatment; clinical intracavitary radiation hyperthermia treatment; and clinical brachytherapy radiation treatment. It is important to note that the information provided in this article serves as a general overview and does not substitute for the specific guidelines and regulations set forth by medical coding authorities. Healthcare providers should consult the most up-to-date resources, such as official CPT coding guidelines and relevant billing regulations, for accurate and compliant coding and billing practices in radiation oncology. The American Medical Association (AMA) periodically releases updates to the CPT code set, including guidelines and instructions for proper code usage. Regularly referring to these updates and consulting with coding experts can help ensure accurate coding and appropriate reimbursement for radiation oncology treatments. About Medical Billers and Coders (MBC) Copyright © Medical Billers and Coders. All Rights Reserved Call now 888-357-3226 (Toll Free) info@medicalbillersandcoders.com 4

5. Visit our website: Click here Follow us: Medical Billers and Coders (MBC) is recognized as a leading radiation oncology billing company, providing comprehensive and specialized billing services tailored specifically to the unique needs of radiation oncology practices. With our deep expertise and extensive knowledge of the ever-evolving medical billing and coding landscape, MBC ensures accurate and efficient revenue cycle management for radiation oncology providers. Our team of skilled professionals is well-versed in the intricacies of radiation oncology coding, including the specific CPT codes, modifiers, and documentation requirements. By partnering with MBC, radiation oncology practices can streamline their billing processes, maximize reimbursement, and focus on delivering exceptional patient care. To know more about our radiation oncology billing services, email us at: info@medicalbillersandcoders.com or call us at: 888-357-3226. CPT® is a registered trademark of the American Medical Association Copyright © Medical Billers and Coders. All Rights Reserved Call now 888-357-3226 (Toll Free) info@medicalbillersandcoders.com 5