How To Use CPT Code 77387

CPT 77387 refers to the guidance for localization of target volume for delivery of radiation treatment, including intrafraction tracking when performed. This article will cover topics such as the description, procedure, qualifying circumstances, when to use the code, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 77387 procedures.

1. What is CPT 77387?

CPT 77387 is a medical billing code used to describe the process of using imaging guidance to locate the target site for the delivery of radiation treatment over a tumor. This code is specifically used when intrafraction tracking is performed during the procedure. The purpose of this code is to ensure accurate delivery of radiation to the tumor site while minimizing exposure to surrounding healthy tissues.

2. 77387 CPT code description

The official description of CPT code 77387 is: “Guidance for localization of target volume for delivery of radiation treatment, includes intrafraction tracking, when performed.”

3. Procedure

The 77387 procedure involves the following steps:

1. Identification of the targeted tumor site using imaging techniques such as X-rays, computed tomography, ultrasound, or other methods.
2. Localization of the target volume for radiation treatment delivery.
3. Use of intrafraction tracking, when performed, to monitor the tumor’s position during treatment and adjust the radiation delivery accordingly.
4. Delivery of radiation treatment to the targeted tumor site while minimizing exposure to surrounding healthy tissues.

4. Qualifying circumstances

Patients eligible to receive CPT code 77387 services are those who require radiation therapy for the treatment of tumors. This code is applicable when imaging guidance is used to localize the target volume and intrafraction tracking is performed during the radiation treatment delivery. The use of this code ensures accurate radiation delivery to the tumor site while minimizing exposure to surrounding healthy tissues.

5. When to use CPT code 77387

It is appropriate to bill the 77387 CPT code when the following conditions are met:

• The patient requires radiation therapy for the treatment of a tumor.
• Imaging guidance is used to localize the target volume for radiation treatment delivery.
• Intrafraction tracking is performed during the radiation treatment delivery to monitor the tumor’s position and adjust the radiation delivery accordingly.

6. Documentation requirements

To support a claim for CPT 77387, the following information needs to be documented:

• Patient’s medical history and diagnosis, including the presence of a tumor requiring radiation therapy.
• Details of the imaging technique used to identify and localize the target volume for radiation treatment delivery.
• Information on the use of intrafraction tracking during the radiation treatment delivery, if performed.
• Details of the radiation treatment delivery, including the targeted tumor site and measures taken to minimize exposure to surrounding healthy tissues.

7. Billing guidelines

When billing for CPT code 77387, keep in mind the following guidelines and rules:

• Do not report the technical component (TC) with codes 77385, 77386, 77371, 77372, or 77373, as the technical component of imaging guidance is bundled into these codes.
• Report CPT 77387 if imaging guidance is performed in conjunction with conventional radiation therapy.
• For placement of interstitial device(s) for radiation therapy guidance, see codes 31627, 32553, 49411, and 55876.

8. Historical information

CPT 77387 was added to the Current Procedural Terminology system on January 1, 2015. The code was changed on January 1, 2019, with the previous descriptor being “Guidance for localization of target volume for delivery of radiation treatment delivery, includes intrafraction tracking, when performed.”

9. Similar codes to CPT 77387

Five similar codes to CPT 77387 and how they differentiate from CPT 77387 are:

• CPT 77385: This code is used for intensity-modulated radiation treatment delivery (IMRT) without the need for intrafraction tracking.
• CPT 77386: This code also refers to IMRT but includes the use of compensators for radiation treatment delivery.
• CPT 77371: This code is used for stereotactic body radiation therapy, which is a specialized form of radiation therapy that delivers high doses of radiation to a small target area.
• CPT 77372: This code is used for stereotactic radiosurgery, a non-invasive procedure that uses focused radiation beams to treat tumors and other abnormalities in the brain.
• CPT 77373: This code is used for image-guided robotic linear accelerator-based stereotactic radiosurgery, which combines imaging guidance with a robotic linear accelerator to deliver precise radiation treatment.

10. Examples

Here are 10 detailed examples of CPT code 77387 procedures:

1. A patient with lung cancer undergoes radiation therapy using imaging guidance to localize the target volume and intrafraction tracking to monitor the tumor’s position during treatment.
2. A patient with prostate cancer receives radiation treatment with imaging guidance for target volume localization and intrafraction tracking to ensure accurate radiation delivery.
3. A patient with breast cancer undergoes radiation therapy using imaging guidance to localize the target volume and intrafraction tracking to adjust the radiation delivery based on the tumor’s position.
4. A patient with brain cancer receives radiation treatment with imaging guidance for target volume localization and intrafraction tracking to minimize exposure to surrounding healthy tissues.
5. A patient with liver cancer undergoes radiation therapy using imaging guidance to localize the target volume and intrafraction tracking to monitor the tumor’s position during treatment.
6. A patient with pancreatic cancer receives radiation treatment with imaging guidance for target volume localization and intrafraction tracking to ensure accurate radiation delivery.
7. A patient with head and neck cancer undergoes radiation therapy using imaging guidance to localize the target volume and intrafraction tracking to adjust the radiation delivery based on the tumor’s position.
8. A patient with cervical cancer receives radiation treatment with imaging guidance for target volume localization and intrafraction tracking to minimize exposure to surrounding healthy tissues.
9. A patient with esophageal cancer undergoes radiation therapy using imaging guidance to localize the target volume and intrafraction tracking to monitor the tumor’s position during treatment.
10. A patient with colorectal cancer receives radiation treatment with imaging guidance for target volume localization and intrafraction tracking to ensure accurate radiation delivery.