How To Use CPT Code 77522

CPT 77522 describes the technical component of a procedure in which a provider administers radiation therapy using a beam of protons to irradiate the 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 77522?

CPT 77522 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 with compensation. It is important to note that CPT 77522 only covers the technical component of the procedure, not the professional component.

2. Official Description

The official description of CPT code 77522 is: ‘Proton treatment delivery; simple, with compensation.’

3. Procedure

1. The provider administers radiation therapy using a beam of protons.
2. The treatment performed is simple, using a single non-tangential port.
3. Compensators are used to shape the radiation beam, maximizing the dose to the tumor and minimizing exposure to healthy tissues.

4. Qualifying circumstances

CPT 77522 is used when a provider delivers simple proton therapy with compensation. This treatment is typically used for deep-seated tumors that are close to sensitive structures like the spinal cord and brain. Proton therapy is advantageous because it delivers a low entrance dose, a high dose within the tumor, and no exit dose beyond the tumor. It is important to note that CPT 77522 only covers the technical component of the procedure, not the professional component.

5. When to use CPT code 77522

CPT code 77522 should be used when a provider performs simple proton treatment delivery with compensation. It is important to ensure that the treatment involves a single non-tangential port and that compensators are used to shape the radiation beam. This code should only be used for the technical component of the procedure, not the professional component.

6. Documentation requirements

To support a claim for CPT 77522, the provider must document the following information:

• Details of the treatment performed, including the use of a proton beam and compensators
• Specifics of the simple treatment delivery, such as the use of a single non-tangential port
• Date and duration of the treatment
• Any additional relevant information, such as the location of the tumor and proximity to sensitive structures

7. Billing guidelines

When billing for CPT 77522, it is important to ensure that the treatment performed meets the criteria for simple proton therapy with compensation. This code should only be reported for the technical component of the procedure, not the professional component. It is also important to follow any additional guidelines provided by payers or coding authorities.

8. Historical information

CPT 77522 was added to the Current Procedural Terminology system on January 1, 2001. There have been no updates to the code since its addition.

9. Examples

1. A provider delivers simple proton therapy with compensation to a patient with a deep-seated brain tumor.
2. A patient receives treatment for a spinal cord tumor using a single non-tangential port and compensators.
3. A provider administers simple proton therapy with compensation to a patient with a tumor near the optic nerve.
4. A patient undergoes treatment for a liver tumor using a proton beam and compensators.
5. A provider delivers simple proton therapy with compensation to a patient with a tumor near the heart.
6. A patient receives treatment for a prostate tumor using a single non-tangential port and compensators.
7. A provider administers simple proton therapy with compensation to a patient with a tumor near the spinal cord.
8. A patient undergoes treatment for a lung tumor using a proton beam and compensators.
9. A provider delivers simple proton therapy with compensation to a patient with a tumor near the esophagus.
10. A patient receives treatment for a head and neck tumor using a single non-tangential port and compensators.