How To Use CPT Code 77523

CPT 77523 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 77523?

CPT 77523 can be used to describe the technical component of a procedure in which a provider administers radiation therapy using a beam of protons to irradiate the cancer. This code specifically represents intermediate level treatment, involving the irradiation of one or more treatment areas using two or more ports or one or more tangential ports, as well as custom blocks and compensators.

2. Official Description

The official description of CPT code 77523 is: ‘Proton treatment delivery; intermediate.’

3. Procedure

1. The provider performs intermediate level treatment using a beam of protons to irradiate the cancer.
2. One or more treatment areas are irradiated using two or more ports or one or more tangential ports.
3. Custom blocks and compensators may be used to shape the radiation beam and minimize exposure to healthy tissues.

4. Qualifying circumstances

CPT 77523 is used when a provider administers radiation therapy using a beam of protons to irradiate the cancer. This treatment is considered intermediate level and involves the irradiation of one or two treatment areas using two or more ports or one or more tangential ports. Custom blocks and compensators may also be used to limit the radiation field to the target area only.

5. When to use CPT code 77523

CPT code 77523 should be used when a provider performs intermediate level proton treatment delivery, irradiating one or two treatment areas using two or more ports or one or more tangential ports. This code should not be used for other types of radiation therapy or for treatment delivery that does not meet the specific criteria outlined in the official description.

6. Documentation requirements

To support a claim for CPT 77523, the provider must document the following information:

• Specific details of the treatment performed, including the number of treatment areas irradiated and the number of ports or tangential ports used
• Use of custom blocks and compensators, if applicable
• Date and duration of the treatment session
• Signature of the provider performing the treatment

7. Billing guidelines

When billing for CPT 77523, ensure that the treatment performed meets the criteria outlined in the official description. This code represents the technical component of the procedure, and it should not be reported with other codes that represent different types of radiation therapy. Providers should follow the specific guidelines provided by the payer when submitting claims for CPT 77523.

8. Historical information

CPT 77523 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 administers intermediate level proton treatment delivery using two ports to irradiate a single treatment area.
2. A patient receives proton therapy for a deep-seated tumor close to sensitive structures, such as the spinal cord or brain, using one tangential port and custom blocks.
3. A provider performs proton treatment delivery using two ports and custom compensators to irradiate two treatment areas.
4. A patient undergoes proton therapy for a tumor near the heart, with treatment delivered using one tangential port and custom blocks.
5. A provider administers intermediate level proton treatment delivery using two ports and custom compensators to irradiate multiple treatment areas.
6. A patient receives proton therapy for a tumor near the lungs, with treatment delivered using one tangential port and custom compensators.
7. A provider performs proton treatment delivery using two ports and custom blocks to irradiate a single treatment area.
8. A patient undergoes proton therapy for a tumor near the liver, with treatment delivered using one tangential port and custom blocks.
9. A provider administers intermediate level proton treatment delivery using two ports and custom compensators to irradiate multiple treatment areas.
10. A patient receives proton therapy for a tumor near the pancreas, with treatment delivered using one tangential port and custom compensators.