How To Use CPT Code 77768

CPT 77768 describes the procedure for remote afterloading high dose rate radionuclide skin surface brachytherapy. 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 77768?

CPT 77768 can be used to describe the procedure of remote afterloading high dose rate radionuclide skin surface brachytherapy. This code is used when the provider treats a skin tumor over 2.0 cm in diameter or multiple lesions, or uses two or more channels to deliver the high energy radioactive substance directly on or near the skin surface. The procedure includes the calculation of the dose of the radioactive substance before loading it into the catheter, when performed.

2. Official Description

The official description of CPT code 77768 is: ‘Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed; lesion diameter over 2.0 cm and 2 or more channels, or multiple lesions.’

3. Procedure

1. In this procedure, the provider places a catheter or an applicator at the treatment site.
2. The provider may calculate the dose based on the type and stage of the cancer being treated.
3. A remote afterloader is used to load the catheter or applicator with high energy radioactive material automatically.
4. This helps deliver a high dose of radiation localized to the tumor site quickly and with limited exposure of surrounding normal tissue to radiation.
5. This procedure is specifically used for skin lesions with a diameter greater than 2.0 cm, the use of two or more channels to deliver the radioactive material, or the treatment of multiple lesions or areas of damaged or diseased tissue.

4. Qualifying circumstances

Qualifying circumstances for CPT 77768 include the treatment of skin lesions with a diameter greater than 2.0 cm, the use of two or more channels to deliver the radioactive material, or the treatment of multiple lesions or areas of damaged or diseased tissue. This procedure is typically performed by a provider experienced in brachytherapy and is used to reduce radiation exposure to surrounding healthy tissues.

5. When to use CPT code 77768

CPT code 77768 should be used when the provider performs remote afterloading high dose rate radionuclide skin surface brachytherapy for skin lesions with a diameter greater than 2.0 cm, uses two or more channels to deliver the radioactive material, or treats multiple lesions or areas of damaged or diseased tissue. It should not be used for lesions with a diameter up to 2.0 cm or when only one channel is used.

6. Documentation requirements

To support a claim for CPT 77768, the provider must document the following information:

• Patient’s diagnosis and the need for remote afterloading high dose rate radionuclide skin surface brachytherapy
• Specific details of the procedure, including the diameter of the skin lesion, the number of channels used, and the treatment of multiple lesions or areas of damaged or diseased tissue
• Date of the procedure
• Calculation of the dose of the radioactive substance before loading it into the catheter, if performed
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 77768, ensure that the procedure meets the qualifying circumstances, such as the treatment of skin lesions with a diameter greater than 2.0 cm, the use of two or more channels, or the treatment of multiple lesions or areas of damaged or diseased tissue. Do not report CPT code 77768 with code 77300, as CPT 77768 already includes the calculation of dose. If the provider treats lesions with a diameter up to 2.0 cm or uses only one channel, report CPT code 77767 instead. If the provider treats tumors in areas other than the skin, report the appropriate codes for interstitial or intracavitary brachytherapy.

8. Historical information

CPT 77768 was added to the Current Procedural Terminology system on January 1, 2016. There have been no updates to the code since its addition.

9. Examples

1. A provider performs remote afterloading high dose rate radionuclide skin surface brachytherapy for a skin tumor with a diameter of 3.0 cm.
2. A provider treats multiple skin lesions using two channels to deliver the radioactive material.
3. A patient has areas of damaged tissue on their skin, and the provider performs remote afterloading high dose rate radionuclide skin surface brachytherapy to treat these areas.
4. A provider calculates the dose of the radioactive substance before loading it into the catheter for a patient with a skin lesion over 2.0 cm in diameter.
5. A provider treats a patient with multiple skin lesions using remote afterloading high dose rate radionuclide skin surface brachytherapy.
6. A patient has a skin tumor with a diameter of 2.5 cm, and the provider uses two channels to deliver the radioactive material.
7. A provider performs remote afterloading high dose rate radionuclide skin surface brachytherapy for a patient with multiple areas of damaged tissue on their skin.