Medical Billing and Coding for Radiation Oncology

[Jostan]

My coding group is billing the 77387 with the 77407, and 80%+ of the time the 77387 is being denied as "included with the 77407", but it's not. Sometimes there are other denial reasons, but we are have difficulty getting this code paid. Depending on the treatment we also bill 77412 with the 77387. Ideas? Thoughts?

 

[sls314]

My coding group is billing the 77387 with the 77407, and 80%+ of the time the 77387 is being denied as "included with the 77407", but it's not. Sometimes there are other denial reasons, but we are have difficulty getting this code paid. Depending on the treatment we also bill 77412 with the 77387. Ideas? Thoughts?

The technical component of 77387 is bundled into treatment delivery. You should not be coding or billing the technical component for 77387. This applies to both outpatient hospital and freestanding centers.

There were some major changes to radiation oncology billing and coding effective January 1, 2026. The treatment delivery CPT codes were revised, and by definition include the imaging guidance:

• 77402 - Radiation treatment delivery; Level 1 (eg, single-electron field, multiple-electron fields, single isocenter 2D photons), including imaging guidance, when performed
• 77407 - Radiation treatment delivery; Level 2, single-isocenter (eg, 3D or IMRT), photons, including imaging guidance, when performed
• 77412 - Radiation treatment delivery; Level 3, multiple isocenters with photon therapy (eg, 2D, 3D, or IMRT) or a single-isocenter photon therapy (eg, 3D or IMRT) with active motion management, or total skin electrons, or mixed-electron/photon field(s), including imaging guidance, when performed

Physicians can still bill for the professional component of IGRT, using 77387-26.

 

[Jostan]

Thank you for taking the time to reply. I appreciate your input. I was under the impression that the code 77387 was also changed to be a professional only code and did not need a modifier 26 anymore. Please respond.

 

[sls314]

Thank you for taking the time to reply. I appreciate your input. I was under the impression that the code 77387 was also changed to be a professional only code and did not need a modifier 26 anymore. Please respond.

You should still use modifier 26 to indicate that you're billing for the professional component.

If a specific payer has instructed you not to append modifier 26, then follow that payer's guidance when billing for that payer.

I code and bill professional-fee radiation oncology services in both the outpatient hospital and freestanding settings. All of my payers still require modifier 26 with 77387.

 

[Jostan]

Thank you for your response. I will pass on the information to the powers that be.