Overview Of Radiation Therapy CPT Codes – Part 1

1
Overview Of Radiation Therapy CPT
Codes Part 1
2
Overview Of Radiation Therapy CPT Codes Part 1

• 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 this article we will overview first 3
  categories of radiation therapy CPT codes.
• Categories of Radiation Therapy CPT Codes
• 1. Consultation
• Consultation in radiation oncology refers to the
  evaluation and assessment of a patients
  condition by a radiation oncologist to determine
  the appropriateness and feasibility of radiation
  therapy. During a consultation, the radiation
  oncologist reviews the patients medical history,
  performs a physical examination, and discusses
  treatment options with the patient. The
  consultation may involve the interpretation of
  diagnostic imaging studies, such as CT scans or
  MRIs, to plan the radiation treatment. This
  category includes CPT codes like,
• Office or other outpatient visits, new patient
  (CPT code range 99202-99205)

3
Overview Of Radiation Therapy CPT Codes Part 1

• Office or other outpatient visits, established
  patient (CPT code range 99211-99215)
• Office or other outpatient consultations, new or
  established patient (CPT code range 99241-99245)
• Inpatient consultations, new or established
  patient (CPT code range 99251-99255)
• Initial hospital care (CPT code range
  99221-99223)
• Subsequent hospital care (CPT code range
  99231-99233)
• When coding for consultation services in
  radiation oncology, it is important to determine
  whether the consultation is for a new patient or
  an established patient. The level of medical
  decision-making and complexity of the evaluation
  should be accurately documented to select the
  appropriate CPT code.
• Ensure that the documentation clearly supports
  the medical necessity and complexity of the
  consultation. Accurate documentation of the
  history, examination, and medical decision-making
  components is essential for proper code
  selection. Consultations in radiation oncology
  are typically performed before initiating
  radiation therapy to assess the patients
  condition and develop an appropriate treatment
  plan. Consultation codes may also be used when a
  patient is referred by another physician for a
  second opinion or specialized expertise in
  radiation oncology.
• 2. Preparing for Treatment
• Preparing for radiation treatment involves
  various activities and services that are
  necessary before the initiation of radiation
  therapy. This may include treatment planning,
  simulation, immobilization, and marking of the
  treatment area.

4
Overview Of Radiation Therapy CPT Codes Part 1

• Additionally, patient education, consent, and the
  creation of treatment setup instructions are part
  of the preparation process. This category
  includes CPT codes like,
• Clinical treatment planning (CPT code range
  77261-77263)
• Simulation (CPT code range 77280-77290)
• Respiratory management simulation (CPT code
  77293)
• When coding for radiation treatment preparation,
  the complexity of the simulation-aided field
  setting should be determined based on the number
  of separate treatment areas and the level of
  effort required. Proper documentation should
  support the complexity of the procedure
  performed. Ensure that the documentation includes
  details regarding the simulation process, field
  setting, and any additional complexities
  involved. Accurate and detailed documentation is
  crucial for correct code assignment.
• 3. Medical Radiation Physics, Dosimetry,
  Treatment Devices, and Special Services
• Medical radiation physics, dosimetry, treatment
  devices, and special services encompass various
  technical aspects and support services involved
  in radiation therapy. This includes the
  measurement and calculation of radiation doses,
  quality assurance procedures, treatment device
  calibration, and the use of specialized equipment
  or techniques for treatment delivery. This
  category includes CPT codes like,

5
Overview Of Radiation Therapy CPT Codes Part 1

• 3-dimensional radiotherapy plan (CPT code 77295)
• Basic dosimetry (CPT code 77300)
• Special dosimetry (CPT code 77331)
• IMRT dose planning (CPT code 77301)
• MLC device for IMRT (CPT code 77338)
• Teletherapy isodose plan (CPT codes 77306, 77307)
• Brachytherapy isodose plan (CPT codes 77316,
  77317, 77318)
• Special teletherapy port plan (CPT code 77321)
• Treatment devices (CPT codes 77332, 77333, 77334)
• Continuing medical physics consultations (CPT
  code 77336)
• Special medical radiation physics consultations
  (CPT code 77370)
• Coding for medical radiation physics, dosimetry,
  treatment devices, and special services requires
  accurate documentation of the specific procedures
  performed. The complexity of the calculations,
  consultations, or plans should be well-documented
  to determine the appropriate CPT code. Ensure
  that the documentation clearly describes the
  technical procedures, calculations, or
  consultations provided. Accurate and detailed
  documentation is crucial for proper code
  assignment.

6
Overview Of Radiation Therapy CPT Codes Part 1
In conclusion, the consultation category involves
the evaluation and assessment of patients to
determine the suitability of radiation therapy.
Preparing for treatment focuses on activities
such as treatment planning and simulation to
ensure accurate delivery of radiation therapy.
Medical radiation physics, dosimetry, treatment
devices, and special services encompass the
technical aspects and support services involved
in radiation therapy. We will overview next three
categories of radiation therapy CPT codes in the
next part of this article. 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_at_medisysdata.com / 888-720-8884
7
(No Transcript)