Oncology & Hematology Coding Alert

Question: If a patient requires a second intensity modulated radiation therapy plan, may I also report CT guidance with CPT 77014 ?

Washington Subscriber

Answer: Correct Coding Initiative edits bundle 77014 (Computed tomography guidance for placement of radiation therapy fields) into 77301 (Intensity modulated radiotherapy plan, including dose-volume histograms for target and critical structure partial tolerance specifications) when these services are performed on the same service date. You may not override this edit. Generally, the CT and the IMRT plan are performed on separate days, so this edit is not a problem.

However, you may report 77301 more than once for a patient in certain circumstances, as well as the second CT dataset.

Example: You can report a second IMRT plan (77301) if you get a second treatment planning CT and contour a new target volume. You-d do this if there are significant volume changes due to tumor reduction or substantial changes in patient body size, requiring a new IMRT plan. The oncologist will need to enter documentation into the treatment record to support the medical necessity of subsequent CTs and of generation of the new plan (such as rationale for volume change).