How To Use CPT Code 77412

CPT 77412 refers to a complex radiation treatment delivery procedure involving three or more treatment areas, specialized blocking, and variations in types of ports and angles or delivery. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 77412 procedures.

1. What is CPT 77412?

CPT 77412 is a code used to represent the technical component of a complex radiation treatment delivery procedure. This procedure involves the delivery of radiation to a treatment area using an energy level of greater than or equal to one MeV (million electron volts). The treatment is characterized by three or more treatment areas, specialized blocking tailored to the individual treatment, variations in types of ports and angles or delivery, and changes in the energy beam itself.

2. 77412 CPT code description

The official description of CPT code 77412 is: “Radiation treatment delivery, >/=1 MeV; complex.”

3. Procedure

The 77412 procedure involves the following steps:

1. The patient is placed on a treatment table.
2. The provider delivers the radiation beam to the targeted body area using an external source of radiation, such as a linear accelerator.
3. The machine generates radiation at different energy levels, with the provider treating the area using greater than or equal to one MeV energy level.
4. The treatment involves three or more treatment areas, specialized blocking tailored to the individual treatment, variations in types of ports and angles or delivery, and changes in the energy beam itself.

4. Qualifying circumstances

Patients eligible to receive CPT code 77412 services are those who require complex radiation treatment delivery due to the presence of multiple treatment areas, the need for specialized blocking, or variations in types of ports and angles or delivery. This may include patients with advanced or aggressive cancers, those with tumors in difficult-to-reach locations, or individuals who require a more customized approach to their radiation therapy.

5. When to use CPT code 77412

It is appropriate to bill the 77412 CPT code when a complex radiation treatment delivery procedure is performed, involving three or more treatment areas, specialized blocking tailored to the individual treatment, variations in types of ports and angles or delivery, and changes in the energy beam itself. This code should be used to represent the technical component of the procedure, not the professional component, which includes the physician’s work in planning and supervising the treatment.

6. Documentation requirements

To support a claim for CPT 77412, the following information should be documented:

• Patient’s medical history and diagnosis, including the type and stage of cancer being treated.
• Details of the radiation treatment plan, including the number of treatment areas, the types of ports and angles used, and any specialized blocking or modifications to the energy beam.
• Records of the radiation treatment delivery, including the date, time, and duration of each session, as well as the total radiation dose delivered.
• Any complications or adverse reactions experienced by the patient during or after the treatment.
• Follow-up care plan, including any additional treatments or interventions required.

7. Billing guidelines

When billing for CPT code 77412, it is important to follow the appropriate guidelines and rules to ensure accurate reimbursement. Some tips and codes that apply to CPT code 77412 include:

• Do not report CPT 77412 in conjunction with CPT 77373.
• For similar services involving a single treatment area, one or two ports, and zero, one, or two simple blocks, use CPT 77402.
• For similar services involving two different treatment areas, each with three or more ports aimed at the area, and three or more blocks, use CPT 77407.

8. Historical information

CPT 77412 was added to the Current Procedural Terminology system on January 1, 1991. Since then, there have been several updates to the code, with the most recent change occurring on January 1, 2020.

9. Similar codes to CPT 77412

Five similar codes to CPT 77412 and how they differentiate from CPT 77412 are:

1. CPT 77402: Represents a simple radiation treatment delivery procedure with a single treatment area, one or two ports, and zero, one, or two simple blocks.
2. CPT 77407: Represents an intermediate radiation treatment delivery procedure with two different treatment areas, each with three or more ports aimed at the area, and three or more blocks.
3. CPT 77373: Represents a stereotactic body radiation therapy treatment management service, which is not to be reported in conjunction with CPT 77412.
4. CPT 77416: Represents a continuous hyperfractionated accelerated radiotherapy (CHART) treatment delivery procedure, which is a more intensive form of radiation therapy.
5. CPT 77424: Represents an intraoperative radiation treatment delivery procedure, which is performed during surgery to target the tumor bed directly.

10. Examples

Here are 10 detailed examples of CPT code 77412 procedures:

1. A patient with advanced lung cancer requires radiation therapy targeting multiple tumor sites within the lung, using specialized blocking and varying port angles to minimize damage to healthy tissue.
2. A patient with a brain tumor requires radiation therapy targeting three separate treatment areas, with customized blocking and variations in port angles to protect surrounding brain structures.
3. A patient with metastatic breast cancer requires radiation therapy targeting multiple lymph node regions, using specialized blocking and varying port angles to minimize damage to healthy tissue.
4. A patient with prostate cancer requires radiation therapy targeting the prostate gland and surrounding lymph nodes, using specialized blocking and varying port angles to protect nearby organs.
5. A patient with head and neck cancer requires radiation therapy targeting multiple tumor sites within the oral cavity, pharynx, and larynx, using specialized blocking and varying port angles to minimize damage to healthy tissue.
6. A patient with advanced cervical cancer requires radiation therapy targeting the cervix, uterus, and surrounding lymph nodes, using specialized blocking and varying port angles to protect nearby organs.
7. A patient with pancreatic cancer requires radiation therapy targeting the pancreas and surrounding lymph nodes, using specialized blocking and varying port angles to minimize damage to healthy tissue.
8. A patient with advanced esophageal cancer requires radiation therapy targeting the esophagus and surrounding lymph nodes, using specialized blocking and varying port angles to protect nearby organs.
9. A patient with advanced rectal cancer requires radiation therapy targeting the rectum and surrounding lymph nodes, using specialized blocking and varying port angles to minimize damage to healthy tissue.
10. A patient with advanced liver cancer requires radiation therapy targeting multiple tumor sites within the liver, using specialized blocking and varying port angles to protect surrounding liver tissue.