How To Use CPT Code 77338

CPT 77338 refers to the design and construction of multi-leaf collimator (MLC) devices for intensity modulated radiation therapy (IMRT) plans. This article covers the description, procedure, qualifying circumstances, usage, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 77338.

1. What is CPT 77338?

CPT 77338 is a medical billing code used to describe the design and construction of multi-leaf collimator (MLC) devices for intensity modulated radiation therapy (IMRT) plans. These devices are essential in delivering precise radiation therapy to tumors while minimizing damage to surrounding healthy tissue.

2. 77338 CPT code description

The official description of CPT code 77338 is: “Multi-leaf collimator (MLC) device(s) for intensity modulated radiation therapy (IMRT), design and construction per IMRT plan.”

3. Procedure

The 77338 procedure involves the following steps:

1. Reviewing the IMRT plan to determine the appropriate MLC device design.
2. Designing the MLC device based on the IMRT plan, taking into consideration the size, shape, and position of the tumor.
3. Constructing the MLC device using specialized computer-controlled equipment.
4. Testing the MLC device to ensure proper functionality and alignment with the IMRT plan.
5. Installing the MLC device in the linear accelerator for use in the IMRT treatment.

4. Qualifying circumstances

Patients eligible to receive CPT code 77338 services are those who require intensity modulated radiation therapy (IMRT) for the treatment of cancerous tumors. The IMRT plan must specifically call for the use of a multi-leaf collimator (MLC) device to deliver the radiation therapy. Additionally, the provider must be involved in the design and construction of the MLC device as per the IMRT plan.

5. When to use CPT code 77338

It is appropriate to bill the 77338 CPT code when a provider is involved in the design and construction of a multi-leaf collimator (MLC) device for intensity modulated radiation therapy (IMRT) as per the patient’s IMRT plan. This code should only be used once per IMRT plan.

6. Documentation requirements

To support a claim for CPT 77338, the following information must be documented:

• Patient’s medical history and diagnosis, including the need for IMRT treatment.
• Details of the IMRT plan, including the requirement for an MLC device.
• Provider’s involvement in the design and construction of the MLC device.
• Specifications of the MLC device, including size, shape, and position of the leaves.
• Installation and testing of the MLC device in the linear accelerator.

7. Billing guidelines

When billing for CPT code 77338, keep in mind the following guidelines:

• Use 77338 only once per intensity modulated radiation therapy plan.
• Append professional component modifier 26 when reporting only the provider’s services.
• Append modifier TC for the technical component of the radiology service, if applicable.
• Do not append a professional or technical modifier when reporting a global service.
• Do not report 77338 in conjunction with 77385 for compensator-based IMRT.
• For immobilization in IMRT treatment, see CPT codes 77332 – 77334.

8. Historical information

CPT 77338 was added to the Current Procedural Terminology system on January 1, 2010. There have been no updates to the code since its addition.

9. Similar codes to CPT 77338

Five similar codes to CPT 77338 and how they differentiate are:

• CPT 77332: Focuses on the design and construction of treatment devices for IMRT, not specifically MLC devices.
• CPT 77333: Involves the design and construction of complex treatment devices, not limited to IMRT or MLC devices.
• CPT 77334: Covers the design and construction of simple treatment devices, not specific to IMRT or MLC devices.
• CPT 77385: Pertains to the planning and delivery of compensator-based IMRT, not the design and construction of MLC devices.
• CPT 77386: Relates to the planning and delivery of MLC-based IMRT, not the design and construction of MLC devices.

10. Examples

Here are 10 detailed examples of CPT code 77338 procedures:

1. A patient with lung cancer requires IMRT, and the provider designs and constructs an MLC device to target the tumor while sparing healthy lung tissue.
2. A patient with prostate cancer undergoes IMRT, and the provider designs and constructs an MLC device to deliver precise radiation therapy to the tumor.
3. A patient with brain cancer requires IMRT, and the provider designs and constructs an MLC device to target the tumor while minimizing damage to healthy brain tissue.
4. A patient with breast cancer undergoes IMRT, and the provider designs and constructs an MLC device to deliver radiation therapy to the tumor while sparing surrounding healthy tissue.
5. A patient with head and neck cancer requires IMRT, and the provider designs and constructs an MLC device to target the tumor while minimizing damage to nearby structures.
6. A patient with pancreatic cancer undergoes IMRT, and the provider designs and constructs an MLC device to deliver precise radiation therapy to the tumor.
7. A patient with liver cancer requires IMRT, and the provider designs and constructs an MLC device to target the tumor while sparing healthy liver tissue.
8. A patient with cervical cancer undergoes IMRT, and the provider designs and constructs an MLC device to deliver radiation therapy to the tumor while minimizing damage to surrounding healthy tissue.
9. A patient with esophageal cancer requires IMRT, and the provider designs and constructs an MLC device to target the tumor while sparing nearby structures.
10. A patient with spinal cancer undergoes IMRT, and the provider designs and constructs an MLC device to deliver precise radiation therapy to the tumor while minimizing damage to the spinal cord.