How To Use CPT Code 77370

CPT 77370 describes a special medical radiation physics consultation that is required under specific circumstances, such as when a patient is receiving radiation treatment and has a pacemaker in or around the treatment area, is pregnant, requires retreatment of the same area, or needs treatment that involves complex interaction of multiple beams. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 77370?

CPT 77370 represents a special medical radiation physics consultation that is requested by the treating provider in certain treatment circumstances. This code specifically represents the technical component of the service, which involves the consultation of a medical radiation physicist to manage complex treatment situations. The radiation physicist plans the course of therapy for the patient, including dose calculation and blocking, and provides a detailed consultative report that is used by the treating provider for delivering treatment.

2. Official Description

The official description of CPT code 77370 is: ‘Special medical radiation physics consultation required under special circumstances (e.g., radiation to a pregnant patient); technical component only.’

3. Procedure

1. In specific treatment circumstances, such as when a patient has a pacemaker in or around the treatment area, is pregnant, requires retreatment of the same area, or needs treatment involving complex interaction of multiple beams, the treating provider requests a special consultation with a medical radiation physicist.
2. The radiation physicist analyzes the specific problem and provides a customized written report that outlines how to deal with the complex treatment situation.
3. The report includes details such as dose calculation, blocking, and other necessary information for delivering treatment.
4. The report is reviewed by the treating provider and used as a guide for the delivery of radiation treatment.

4. Qualifying circumstances

CPT 77370 is used when a special medical radiation physics consultation is required under specific circumstances. These circumstances may include a patient having a pacemaker in or around the treatment area, a pregnant patient, retreatment of the same area, or treatment requiring complex interaction of multiple beams. The consultation is requested by the treating provider to manage the complex treatment situation and ensure the safe and effective delivery of radiation therapy.

5. When to use CPT code 77370

CPT code 77370 should be used when a treating provider requests a special medical radiation physics consultation in specific treatment circumstances. It is important to note that a positive pregnancy test alone is not sufficient to report this code. The treatment plan must be complex enough to require the expertise of a qualified physicist, and the physicist must provide a customized written report that justifies the use of CPT code 77370.

6. Documentation requirements

To support a claim for CPT code 77370, the following documentation is required:

• A request from the treating physician to the physicist for a written analysis of how to deal with the specific treatment problem
• A customized written report from the physicist, including details such as dose calculation, blocking, and other necessary information for delivering treatment
• Inclusion of the report in the patient’s chart

7. Billing guidelines

When billing for CPT code 77370, it is important to note that this code represents the technical component only, and therefore, modifiers 26 or TC should not be appended. It is also important to ensure that the treatment circumstances meet the qualifying criteria for this code. Additionally, it is essential to provide the necessary documentation, including the request from the treating physician and the customized written report from the physicist, to justify the use of CPT code 77370.

8. Historical information

CPT code 77370 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 patient with a pacemaker in the treatment area requires a special medical radiation physics consultation to determine the appropriate radiation therapy plan.
2. A pregnant patient needs a customized treatment plan that takes into account the safety of the fetus, requiring a special medical radiation physics consultation.
3. A complex treatment involving the interaction of multiple beams, such as electron and photon, necessitates a special medical radiation physics consultation to ensure accurate dose calculation and blocking.
4. A patient requires retreatment of the same area, and a special medical radiation physics consultation is needed to develop an effective treatment plan.
5. A treatment plan involves a unique situation that requires the expertise of a medical radiation physicist, leading to a special medical radiation physics consultation.