Oncology & Hematology Coding Alert

Question: How should we report the simulations performed to check applicator position in patients with breast cancer receiving HDR brachytherapy?

Answer: Simulations performed to confirm or correct applicator position -- after the initial simulation -- merit 77280 (Therapeutic radiology simulation-aided field setting; simple), according to CPT Assistant (April 2009).

For the initial simulation, 77290 (... complex) may fit the bill. According to CPT Assistant, the complex simulation involves taking images of the implanted region so the radiation team can make position adjustments and perform dose calculations. The team images permanent implanted sources or uses nonradioactive sources to determine where to place the radioactive sources in temporary implant devices.