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Part B Insider (Multispecialty) Coding Alert

Carrier Requirements For Stereotactic Radiosurgery

Published on Fri Jun 11, 2004

According to a local coverage decision by Part B carrier Blue Cross & Blue Shield of Arkansas, diagnoses that support stereotactic radiosurgery include:

  • disabling symptomology in trigeminal neuralgia and Parkinson's Disease which have become "refractive to medical treatment;"
  • primary central nervous system malignancies generally under 4 cm;
  • primary and secondary tumors of the skull base or nasopharyngeal malignancies;
  • benign brain tumors, such as meningiomas and acoustic neuromas;
  • arteriovenous malformations and hemangiomas that aren't suited for other treatment modalities;
  • boost treatment for larger lesions that have been treated initially with external beam radiation therapy or surgery;
  • metastatic brain lesions, generally fewer than four in number, with exceptions for very slow-growing malignancies;
  • patients with "excellent performance status" whose systemic disease is under control and otherwise have a long survival expectation; and
  • a relapse in a field that's already been irradiated, after at least six months have passed.

    The Arkansas Blues also spell out that you can bill separately for 77332-77334 (for design and construction of treatment devices) in addition to SRS planning using G0242 or G0338.

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