Radiology Coding Alert

Question: How should I report IMRT treatment planning for a head and neck cancer patient? California Subscriber Answer: When you're coding IMRT for head and neck cancers, report 77301 (Intensity modulated radiotherapy plan, including dose-volume histograms for target and critical structure partial tolerance specifications) for treatment planning. Pay attention: For compensator-based IMRT, you should report 0073T (Compensator-based beam modulation treatment delivery of inverse planned treatment using three or more high-resolution [milled or cast] compensator convergent beam modulated fields, per treatment session) with 77301 for treatment planning. Tip: Payers may cover IMRT for certain head and neck cancer diagnoses, including nasopharyngeal carcinoma (such as 230.0, Carcinoma in situ of digestive organs; lip, oral cavity, and pharynx). Benefit to patient: IMRT's conformal radiation planning and delivery target lesions better than standard techniques, limiting side effects (such as xerostomia, 527.7, Disturbance of salivary secretion [xerostomia]) and sparing surrounding normal tissue. You're most likely to see the physician document IMRT with diagnoses including cancer of the tongue (141.x), oropharynx (146.x) and nasopharynx (147.x). You may also see IMRT for carcinoma in situ of the mouth or pharynx (230.0).