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Radiation oncology encompasses a wide range of medical procedures and services aimed at providing effective and targeted radiation therapy to patients with cancer. Within this field, there are six distinct code categories that play crucial roles in the comprehensive care of patients undergoing radiation treatment. These 6 categories are consultation; preparing for treatment, medical radiation physics, dosimetry, treatment devices, and special services; radiation treatment delivery; radiation treatment management; and follow-up care management. Each of these code categories plays a critical role in the comprehensive care provided by radiation oncology professionals, ensuring accurate treatment planning, precise delivery, and ongoing management of radiation therapy for patients with cancer. In the first part of this article overviewed first 3 categories of radiation therapy CPT codes. In this part, we will overview remaining three categories i.e., radiation treatment delivery; radiation treatment management; and follow-up care management.
Categories of Radiation Therapy CPT Codes
4. Radiation Treatment Delivery
Radiation treatment delivery refers to the administration of radiation therapy to the patient as per the prescribed treatment plan. It involves the use of linear accelerators, brachytherapy devices, or other specialized equipment to deliver therapeutic doses of radiation to the targeted treatment area. This category includes CPT codes like,
- Radiation treatment delivery, superficial and/ or orthovoltage (CPT code 77401)
- Radiation treatment delivery (CPT codes 77402, 77407, 77412)
- Radiation treatment delivery (G-codes) (G6003, G6014)
- IMRT treatment delivery (CPT codes 77385, 77386)
- IMRT treatment delivery (G-codes) (G6015, G6016)
- Port images (CPT code 77417)
- IGRT (CPT code 77387)
- IGRT (G-codes) (G6001, G6002, G6017)
- CT guidance (CPT code 77014)
- Proton treatment delivery (CPT code range 77520-77525)
- Neutron treatment delivery (CPT codes 77422, 77423)
- SRS treatment delivery (CPT codes 77371, 77372)
- SBRT treatment delivery (CPT code 77373)
- Hyperthermia (CPT code range 77600- 77620)
- LDR Brachytherapy (CPT code 77778)
- HDR Brachytherapy (CPT codes 77770, 77771, 77772)
- Electronic Brachytherapy (0394T- 0395T)
- IORT (CPT codes 77424, 77425)
- Surface application of radiation source (CPT code 77789)
- Infusion or installation of radioelement solution (CPT code 77750)
- Intracavitary radiation (CPT codes 77761, 77762, 77763)
- Supervision and handling (CPT code 77790)
The complexity and extent of radiation treatment delivery determine the appropriate CPT code selection. The number of separate treatment areas and the level of effort required should be documented to support the code assignment. Ensure that the documentation includes details about the complexity of the treatment delivery, the number of treatment areas, and any additional complexities involved. Accurate and detailed documentation is essential for proper code assignment.
5. Radiation Treatment Management
Radiation treatment management involves the ongoing supervision and monitoring of a patient undergoing radiation therapy. It includes the assessment of treatment progress, management of treatment-related side effects, modification of treatment plans when necessary, and coordination with other healthcare professionals involved in the patient’s care. This category includes CPT codes like,
- Radiation treatment management (CPT codes 77427, 77431)
- SRS treatment management (CPT code 77432)
- SBRT treatment management (CPT code 77435)
- Intraoperative treatment management (CPT code 77469)
- Special treatment procedure (CPT code 77470)
The appropriate CPT code selection for radiation treatment management is based on the number of separate treatment areas and the frequency of management. Proper documentation of the services rendered and the complexity of the management is essential for accurate code assignment. Ensure that the documentation clearly supports the ongoing management and supervision of radiation therapy. Accurate and detailed documentation is crucial for proper code assignment.
6. Follow-up Care Management
Follow-up care management in radiation oncology involves the ongoing evaluation, monitoring, and coordination of care for patients who have completed radiation therapy. It includes regular follow-up visits, imaging studies, and assessment of treatment response, as well as the management of late effects or potential recurrence. Applicable codes for this category includes office or other outpatient visits for the evaluation and management of an established patient i.e., CPT code range 99211 – 99215.
When coding for follow-up care management, the appropriate CPT code selection is based on the level of complexity of the evaluation and management services provided. The documentation should support the medical necessity and complexity of the visit. Ensure that the documentation clearly describes the evaluation and management services provided during the follow-up visit. Accurate and detailed documentation is essential for proper code assignment.
In conclusion, the radiation treatment delivery category involves the administration of radiation therapy using specialized equipment and techniques. Radiation treatment management focuses on the ongoing supervision, monitoring, and modification of treatment plans during radiation therapy. Follow-up care management involves the evaluation, monitoring, and coordination of care for patients who have completed radiation therapy. We hope that first and second part of this article has given you complete overview of radiation therapy CPT codes.
About Medisys Data Solutions (MDS)
Medisys Data Solutions (MDS) is a leading oncology billing company that specializes in providing comprehensive billing and coding services for radiation oncology practices. With our expertise in the complex and ever-changing field of radiation oncology coding and reimbursement, MDS ensures accurate and compliant billing practices for the clients. Our commitment to excellence and attention to detail make us a trusted partner for oncology practices. Contact Medisys Data Solutions today at info@medisysdata.com / 888-720-8884
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