Cpt 77470
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Please see the criteria of billing this code.may be works for you...
77470 Special treatment procedure (e.g., total body irradiation, hemibody radiation, per oral or
endocavitary irradiation
A special treatment procedure may be utilized for circumstances that require extra and inordinate
amounts of time and effort by the staff and the physician, which is medically necessary for the patient and
not routine to the service being performed. The use of this procedure code would be appropriate when
the ?planned course of therapy? is considered above and beyond the standard for the service performed.
For example, routine IMRT or 3D conformal planning and treatment methods are not approved for a
special treatment procedure; however, patient circumstances requiring additional planning or treatment
time, in addition to a routine 3D or IMRT course of therapy, may qualify. Another example is concurrent
chemotherapy. If a chemotherapy regimen requires the radiation oncologist to take this information into
account when prescribing radiation, then the additional consideration might be considered above and
beyond the standard of care.
It is not appropriate for this code to be billed when a patient has another ongoing medical diagnosis such
as diabetes, COPD or hypertension, which is unrelated to the treatment of cancer.
Standards for CPT? 77470
? Special treatment procedure (CPT? 77470) must be requested by the provider.
? Maximum quantity of special treatment procedures (CPT? 77470) allowed per course of treatment
is one (1).
? When requested in conjunction with stereotactic radiotherapy, brachytherapy or concurrent
chemotherapy, one (1) special treatment procedure (CPT? 77470) may be approved.
? CPT? 77470 is NOT authorized for the sole use of 3D conformal therapy or IMRT. CPT? 77470
may be approved for circumstances above and beyond the routine planning and treatment of
these modalities.
? CPT? 77470 will not be routinely allowed merely for the receipt of concurrent chemotherapy but
instead be based upon documented medical necessity requiring extensive work on the part of the
physician and staff as a result of the chemotherapy in combination with radiation therapy
? When a special treatment procedure is requested with 2D, 3D or IMRT courses of therapy,
patient specific medical necessity rationale is required. CPT? 77470 may be approved if ALL of
the following criteria are met: