How To Use CPT Code 77285

CPT 77285 describes the procedure of therapeutic radiology simulation-aided field setting, specifically for intermediate cases. This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 77285?

CPT 77285 can be used to describe the procedure of therapeutic radiology simulation-aided field setting for intermediate cases. This code is used when the provider utilizes a simulator or other imaging modality to determine the size and location of ports to be used for radiation therapy.

2. Official Description

The official description of CPT code 77285 is: ‘Therapeutic radiology simulation-aided field setting; intermediate.’

3. Procedure

1. The provider performs the radiation treatment simulation-aided field setting by deciding on the size and location of the ports for radiotherapy.
2. The provider uses a special X-ray machine or a CT scanner, called a simulator, or another diagnostic imaging machine to determine the size and location of the ports.
3. The procedure may involve intermediate simulation in two discontinuous anatomic locations, three or more converging ports, or multiple blocks to simulate proposed cancer radiotherapy.
4. The goal of this procedure is to ensure that the patient receives the full benefit of radiation for the tumor with minimal impact on other parts of the body.

4. Qualifying circumstances

CPT 77285 is performed by radiation oncologists or providers in the field of radiation therapy. It is used for intermediate cases where the provider needs to determine the size and location of ports for radiotherapy. The procedure may involve two discontinuous anatomic locations, three or more converging ports, or multiple blocks to simulate proposed cancer radiotherapy.

5. When to use CPT code 77285

CPT code 77285 should be used when the provider needs to perform therapeutic radiology simulation-aided field setting for intermediate cases. It is important to accurately determine the size and location of ports for radiotherapy to ensure effective treatment of the tumor while minimizing impact on surrounding tissues.

6. Documentation requirements

To support a claim for CPT 77285, the provider must document the following information:

• Details of the therapeutic radiology simulation-aided field setting procedure
• Specific imaging modality used (e.g., X-ray machine, CT scanner)
• Size and location of the ports determined during the simulation
• Reason for performing the procedure
• Any additional relevant information or findings
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 77285, ensure that the procedure is performed for intermediate cases and that the documentation supports the medical necessity of the simulation-aided field setting. It is important to append the appropriate modifiers (e.g., modifier 26 for professional component, modifier TC for technical component) based on the specific circumstances and payer requirements.

8. Historical information

CPT 77285 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.

9. Examples

1. A radiation oncologist performing therapeutic radiology simulation-aided field setting for an intermediate case of lung cancer.
2. A provider using a simulator to determine the size and location of ports for radiotherapy in an intermediate case of breast cancer.
3. A radiation therapist utilizing a CT scanner to plan the radiation treatment for an intermediate case of prostate cancer.
4. A provider performing therapeutic radiology simulation-aided field setting for an intermediate case of brain tumor.
5. A radiation oncologist using a special X-ray machine to determine the size and location of ports for radiotherapy in an intermediate case of head and neck cancer.
6. A provider performing therapeutic radiology simulation-aided field setting for an intermediate case of colorectal cancer.
7. A radiation therapist utilizing a simulator to plan the radiation treatment for an intermediate case of cervical cancer.
8. A provider using a CT scanner to determine the size and location of ports for radiotherapy in an intermediate case of pancreatic cancer.
9. A radiation oncologist performing therapeutic radiology simulation-aided field setting for an intermediate case of lymphoma.
10. A provider utilizing a special X-ray machine to plan the radiation treatment for an intermediate case of liver cancer.