How To Use CPT Code 77520

CPT 77520 describes the technical component of a procedure in which a provider administers radiation therapy using a beam of protons to irradiate cancer. 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 77520?

CPT 77520 can be used to describe the technical component of a procedure in which a provider delivers radiation therapy using a beam of protons to treat cancer. This code specifically represents simple treatment delivery, using a single non-tangential port and without compensators.

2. Official Description

The official description of CPT code 77520 is: ‘Proton treatment delivery; simple, without compensation.’

3. Procedure

1. The provider administers radiation therapy using a beam of protons.
2. The treatment is simple and involves using a single non-tangential port.
3. No compensators are used during the treatment.

4. Qualifying circumstances

CPT 77520 is used when a provider performs simple proton therapy treatment using a single non-tangential port and without compensators. Proton therapy involves irradiating cancer cells with a proton beam, which interferes with the DNA of tumor cells and minimizes their ability to multiply. This treatment is advantageous for deep-seated tumors close to sensitive structures like the spinal cord and brain.

5. When to use CPT code 77520

CPT code 77520 should be used when a provider delivers simple proton therapy treatment using a single non-tangential port and without compensators. It is important to accurately document the specific details of the treatment to support the use of this code.

6. Documentation requirements

To support a claim for CPT 77520, the provider must document the following information:

• Details of the proton therapy treatment delivered
• Specific use of a single non-tangential port
• Absence of compensators during the treatment

7. Billing guidelines

When billing for CPT 77520, ensure that the treatment delivered meets the criteria of simple proton therapy without compensation. It is important to accurately report the details of the treatment and follow any additional guidelines provided by payers. Use modifier 26 for professional component billing and modifier TC for technical component billing.

8. Historical information

CPT 77520 was added to the Current Procedural Terminology system on January 1, 2000. There have been no updates or changes to the code since its addition.

9. Examples

1. A provider delivers simple proton therapy treatment using a single non-tangential port for a patient with prostate cancer.
2. A provider administers radiation therapy using a beam of protons to treat a deep-seated tumor close to the spinal cord, using a single non-tangential port and without compensators.
3. A patient with brain cancer receives simple proton therapy treatment using a single non-tangential port and without compensators.
4. A provider delivers simple proton therapy treatment using a single non-tangential port for a pediatric patient with a rare form of cancer.
5. A provider administers radiation therapy using a beam of protons to treat a tumor near the optic nerve, using a single non-tangential port and without compensators.
6. A patient with lung cancer receives simple proton therapy treatment using a single non-tangential port and without compensators.
7. A provider delivers simple proton therapy treatment using a single non-tangential port for a patient with liver cancer.
8. A provider administers radiation therapy using a beam of protons to treat a tumor near the heart, using a single non-tangential port and without compensators.
9. A patient with head and neck cancer receives simple proton therapy treatment using a single non-tangential port and without compensators.
10. A provider delivers simple proton therapy treatment using a single non-tangential port for a patient with breast cancer.