How To Use CPT Code 77432

CPT 77432 describes the management of stereotactic radiation treatment for cranial lesions. 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 77432?

CPT 77432 can be used to describe the management of stereotactic radiation treatment for cranial lesions. This code represents the professional component of the treatment, where the provider delivers high doses of radiation to small, well-defined tumors inside the brain using a three-dimensional coordinate system. The provider uses previously taken CT or MRI images to locate the target area and destroys one or more cranial lesions with precision using externally generated ionized radiation.

2. Official Description

The official description of CPT code 77432 is: ‘Stereotactic radiation treatment management of cranial lesion(s) (complete course of treatment consisting of 1 session).’ It is important to note that the same physician should not report both stereotactic radiosurgery services and radiation treatment management for cranial lesions.

3. Procedure

1. The provider uses a three-dimensional coordinate system to locate small targets or lesions inside the brain.
2. Previously taken CT or MRI images are imported into a computer system to provide three-dimensional images of brain structures.
3. The provider delivers high doses of radiation to the target area, destroying one or more cranial lesions.
4. The provider performs the patient’s examination for medical evaluation and management, including assessing the patient’s response to treatment, coordinating care and treatment, and reviewing imaging and/or lab test results.
5. The provider reviews port films, dosimetry, dose delivery, and other treatment parameters.
6. The provider evaluates the treatment set up and the use of blocks and wedges.

4. Qualifying circumstances

CPT 77432 is used for the management of stereotactic radiation treatment for cranial lesions. The provider must use a three-dimensional coordinate system to locate small targets or lesions inside the brain and deliver high doses of radiation to destroy them. This code represents the professional component of the treatment and should not be reported by the same physician who performs stereotactic radiosurgery services for cranial lesions.

5. When to use CPT code 77432

CPT code 77432 should be used to report the provider’s professional contribution to the management of stereotactic radiation treatment for cranial lesions. It is appropriate when the provider delivers high doses of radiation to small, well-defined tumors inside the brain using a three-dimensional coordinate system. This code represents the complete course of treatment consisting of one session.

6. Documentation requirements

To support a claim for CPT 77432, the provider must document the following information:

• Identification of the target area inside the brain using the stereotactic method
• Review of previously taken CT or MRI images to locate the small targets or lesions
• Date and duration of the treatment session
• Patient’s response to treatment
• Coordination of care and treatment
• Review of imaging and/or lab test results
• Review of port films, dosimetry, dose delivery, and other treatment parameters
• Evaluation of treatment set up and the use of blocks and wedges

7. Billing guidelines

When billing for CPT 77432, it is important to note that this code represents the professional component only and should not be reported with modifier 26 or TC. The provider delivering the stereotactic radiation treatment for cranial lesions should not report both stereotactic radiosurgery services and radiation treatment management for cranial lesions. It is also important to consider the location of the testing when coding these treatments.

8. Historical information

CPT 77432 was added to the Current Procedural Terminology system on January 1, 1994. There have been historical changes to the code, including updates to the description and the addition of notes regarding the reporting of other related codes.

9. Examples

1. A radiation oncologist managing the stereotactic radiation treatment for a patient with a small brain tumor.
2. A neurosurgeon overseeing the delivery of high doses of radiation to a well-defined lesion inside the brain.
3. A radiation therapist coordinating the care and treatment of a patient undergoing stereotactic radiation treatment for cranial lesions.
4. A medical physicist reviewing imaging and lab test results to ensure the accuracy of the treatment parameters for a patient receiving stereotactic radiation treatment.
5. A radiation oncology nurse evaluating the treatment set up and the use of blocks and wedges during a session of stereotactic radiation treatment for cranial lesions.
6. A radiation therapist performing the patient’s examination for medical evaluation and management during the course of stereotactic radiation treatment.
7. A radiation oncologist assessing the patient’s response to treatment and adjusting the treatment plan accordingly.
8. A dosimetrist reviewing port films and dosimetry to calculate the radiation dose absorbed by the patient.
9. A radiation oncology resident participating in the management of stereotactic radiation treatment for cranial lesions under the supervision of an attending physician.
10. A radiation therapist providing patient education and support throughout the course of stereotactic radiation treatment for cranial lesions.