Radiology Coding Alert
Include 77295 in IMRT Plan Code
Question: May I code CPT 77301 with CPT 77295 ?
Washington Subscriber
Answer: Generally, you shouldn't report these two codes together. Code 77301 (Intensity modulated radiotherapy plan, including dose-volume histograms for target and critical structure partial tolerance specifications) includes the services described by 77295 (Therapeutic radiology simulation-aided field setting; three-dimensional), according to the American College of Radiology and most payers.
Intensity modulated radiotherapy (IMRT) planning (77301) includes dose verification and positional accuracy plans, dose volume histograms for target and critical structure partial tolerances, and inverse plan optimization for highly conformal distributions.
Because the partial tolerance verification used to maximize the dose to the tumor while minimizing the doseto the surrounding tissues is included in 77301, you should not report it separately with 77331 (Special dosimetry [e.g., TLD, microdosimetry] [specify], only when prescribed by the treating physician) or 77370 (Special medical radiation physics consultation).
This service (77301) also includes generating required isodose curves, so you typically won't be reimbursed for teletherapy codes 77305-77321 if you report them with 77301. Report 77301 once per course of treatment.
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Question: May I code CPT 77301 with CPT 77295 ?
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