How To Use CPT Code 77262

CPT 77262 describes the clinical treatment planning for radiation therapy using external and internal sources. This article will cover the description, official details, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 77262?

CPT 77262 can be used to describe the clinical treatment planning process for radiation therapy. It involves the provider determining the location and number of ports for radiation beams, designing and placing shielding blocks, and selecting the appropriate therapy mode. This code encompasses both external and internal sources of radiation therapy.

2. Official Description

The official description of CPT code 77262 is: ‘Therapeutic radiology treatment planning; intermediate.’

3. Procedure

1. The provider begins by deciding the location and number of ports for the radiation beams to enter the body.
2. They then design and place shielding blocks to protect critical or sensitive organs.
3. The provider selects the appropriate therapy mode, such as arc therapy or brachytherapy.
4. If necessary, they interpret special tests for localizing tumor volume.
5. The treatment planning may involve a single mode or a combination of different modes of therapy.

4. Qualifying circumstances

CPT 77262 is used for intermediate simulation-aided field settings that require treatment planning for two separate noncontiguous treatment areas. This level of planning involves a moderate level of difficulty, including three or more converging ports, multiple blocks for organ protection, special time dose constraints, and interpretation of special tests like MRI. It is typically used for superficial orthovoltage, cobalt, linear accelerator, or photon services.

5. When to use CPT code 77262

CPT code 77262 should be used when the treatment planning involves two separate noncontiguous treatment areas and requires a moderate level of complexity. It is appropriate for cases that involve superficial orthovoltage, cobalt, linear accelerator, or photon services. If the treatment planning involves a single treatment area or more than two noncontiguous treatment areas, different codes should be used.

6. Documentation requirements

To support a claim for CPT 77262, the provider must document the following information:

• Relevant normal and abnormal target anatomy
• Images and data acquired during the simulation process
• Optimal radiation treatment process developed for the patient
• Number of treatment areas and their locations
• Special tests interpreted for localizing tumor volume

7. Billing guidelines

When billing for CPT 77262, ensure that the treatment planning involves two separate noncontiguous treatment areas and meets the criteria for intermediate complexity. It is important to follow the guidelines for reporting radiation therapy codes and to use the appropriate modifiers if necessary. CPT code 77262 should not be reported with codes 77261, 77263, or other codes that describe isodose plans or treatment planning services.

8. Historical information

CPT 77262 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates or changes to the code since its addition.

9. Examples

1. A patient requires treatment planning for radiation therapy involving two separate noncontiguous treatment areas using superficial orthovoltage.
2. A provider performs treatment planning for radiation therapy using cobalt for two separate noncontiguous treatment areas.
3. A patient needs treatment planning for radiation therapy involving two separate noncontiguous treatment areas using a linear accelerator.
4. A provider conducts treatment planning for radiation therapy using photon services for two separate noncontiguous treatment areas.
5. A patient requires treatment planning for radiation therapy involving two separate noncontiguous treatment areas with multiple blocks for organ protection.
6. A provider performs treatment planning for radiation therapy using superficial orthovoltage for two separate noncontiguous treatment areas with special time dose constraints.
7. A patient needs treatment planning for radiation therapy involving two separate noncontiguous treatment areas with interpretation of special tests like MRI.
8. A provider conducts treatment planning for radiation therapy using cobalt for two separate noncontiguous treatment areas with multiple blocks for organ protection.
9. A patient requires treatment planning for radiation therapy involving two separate noncontiguous treatment areas using a linear accelerator with special time dose constraints.
10. A provider performs treatment planning for radiation therapy using photon services for two separate noncontiguous treatment areas with interpretation of special tests like MRI.