Coding Radiation Oncology


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I have several questions and am willing to pay a consultant to help

1) For IMRT (Intense modulated radiation therapy) what codes if any are bundled into the code 77301 for Professional charges ? They may or may not include complex sim 77290, image guidance 77014 and G6002 and verification sim 77280 or others

2) What is needed to document for the complex sim 77290 charge on the first day of Cyber knife Stereotactic Treatment

3) When we do a dry run for s stereotactic lung treatment, cane we charge a complex sim 77290 or only a simple sim 77280 ? This procedure involves placing the patient on the treatment table wearing an LED vest, tracking the respiratory motion and setting up a sinusoidal computer model of it, then using orthogonal KV imaging to find and track the nodule as it moves within the lung. If we are able to track it, the patient will need to have an invasive procedure to have a gold marker placed so that the gold marker can be tracked.

4) For occasional patients who receive multimodality treatments (chemotherapy or surgery in addition to radiation), Doc makes an immobilization devise and gets a CT scan in treatment position up front before the chemotherapy or surgery, as she expects the tumor to hange in size. This facilitates later positioning localization, drawing the tumor volume and placing fields. What is the appropriate code to charge for this procedure ?

5) This are unique to Tennessee carriers as well just FYI