Reimbursement

Below are basic coding and reimbursement guidelines—provided by Revenue Cycle Incorporated (RCI) —for US-based users of the Hi·Art® treatment system.

RCI is an independent consulting, billing and development company specializing in oncology. Specific services from RCI are available, at no cost, to all US Tomo® users.

Please note: Guidelines are for reference only, and we encourage all customers to research applicability and accuracy on a patient-by-patient basis.

CPT/ HCPCS Code Pre-Planning, Dosimetry & Physics APC
77014-TC Computed tomography guidance for placement of radiation therapy fields N/A
77261-77263 Therapeutic radiology treatment planning N/A
77280 Therapeutic radiology simulation-aided field setting; simple 0304
77290 Therapeutic radiology simulation-aided field setting; complex 0305
77300 Basic radiation dosimetry calculation, central axis depth dose calculation, TDF, NSD, gap calculation, off axis factor, tissue inhomogeneity factors, calculation of non-ionizing radiation surface and depth dose, as required during course of treatment, only when prescribed by the treating physician 0304
77334 Treatment devices, design and construction; complex (irregular blocks, special shields, compensators, wedges, molds or casts) 0303
77336 Continuing medical physics consultation, including assessment of treatment parameters, quality assurance of dose delivery, and review of patient treatment documentation in support of the radiation oncologist, reported per week of therapy 0304
77370 Special medical radiation physics consultation 0304
CPT/ HCPCS Code 3D Conformal Planning, Treatment Delivery & Management APC
77295 Therapeutic radiology simulation-aided field setting; 3 dimensional 0310
77413 Radiation treatment delivery, 3 or more separate treatment areas, custom blocking, tangential ports, wedges, rotational beam, compensators, 6-10 MeV 0301
77427 Radiation treatment management, 5 treatments N/A

CPT/ HCPCS Code IMRT Planning, Treatment Delivery & Management APC
77301 Intensity modulated radiotherapy plan, including dose-volume histograms for target and critical structure partial tolerance specifications 0310
77338 Multi-leaf collimator (MLC) device(s) for intensity modulated radiation therapy (IMRT), design and construction per IMRT plan 0303
77418 Intensity modulated treatment delivery, single or multiple fields/arcs, via narrow spatially and temporally modulated beams, binary, dynamic MLC, per treatment session 0412
77427 Radiation treatment management, 5 treatments N/A

CPT/HCPCS Code Stereotactic Planning, Treatment Delivery & Management APC
77295 Therapeutic Therapeutic radiology simulation-aided field setting; 3 dimensional 0310
G0339 Image-guided robotic linear accelerator-based stereotactic radiosurgery, complete course of therapy in one session or first session of fractionated treatment 0067
G0340 Image-guided robotic linear accelerator-based stereotactic radiosurgery, delivery including collimator changes and custom plugging, fractionated treatment, all lesions, per session, second through fifth sessions, maximum five sessions per course of treatment 0066
G0173 Linear accelerator based stereotactic radiosurgery, complete course of therapy in one session 0067
G0251 Linear accelerator based stereotactic radiosurgery, delivery including collimator changes and custom plugging, fractionated treatment, all lesions, per session, maximum five sessions per course of treatment 0065
77372 Radiation treatment delivery, stereotactic radiosurgery (SRS), complete course of treatment of cranial lesion(s) consisting of 1 session; linear accelerator based N/A
77373 Stereotactic body radiation therapy, treatment delivery, per fraction to 1 or more lesions, including image guidance, entire course not to exceed 5 fractions N/A
77432 Stereotactic radiation treatment management of cranial lesion(s) (complete course of treatment consisting of 1 session) N/A
77435 Stereotactic body radiation therapy, treatment management, per treatment course, to 1 or more lesions, including image guidance, entire course not to exceed 5 fractions N/A
HCPCS: Healthcare Common Procedure Coding System
CPT: Common Procedural Term
APC: Ambulatory Payment Classification

Disclaimer: This page and its contents has been prepared by Revenue Cycle Incorporated for demonstration purposes only and is not intended to be all-inclusive for a specific patient or procedure. Revenue Cycle Inc. makes no representation as to the appropriateness of these CPT codes for particular billing situations. It is the freestanding facility’s, hospital’s and/or physician’s responsibility to properly code and seek reimbursement for services provided according to Medicare’s rules and regulations. All procedure codes performed should be documented and billed according to payer guidelines.

Current Procedural Terminology (CPT®) © 2009 American Medical Association. All Rights Reserved.