ROCC Radiation Oncology Coding Questions
& Answers Latest Update
1
Question:
Complex Treatment Devices
Can 77334 TC and 26 be billed on different days?
Answer:
CMS has covered Complex Treatment Devices extensively under the Billing and Coding Guidelines.
2
Question:
There was a previous OIG report in which a complex simulation code was billed several days prior to the
IMRT planning code and it was considered unbundling. Is there a timeframe associated with the
unbundling of codes in relationship to the IMRT planning?
Answer:
CPT® codes 77280, 77285, and 77290 describe the process of defining relevant normal and abnormal
target anatomy and acquiring the images and data necessary to develop the optimal radiation treatment
process for the patient. These codes may be billed separately ithey are not a part of the IMRT treatment
plan and may not be billed with CPT® 77301.
3
Question:
What are the documentation requirements for 77334?
Answer:
CPT® code 77334 is for complex treatment devices, design, and construction that include customized,
single-use bolus, such as wax molds conformed to a particular patient body part; customized blocks (low
temperature alloy); customized compensators; wedges; molds or casts; custom-made immobilization
devices, or eye-shields. Custom-made immobilization include restraining devices such as aquaplast and
alpha cradle. The use of passive restraints such as straps, pillows, sandbags, etc. are not billable.
, 4
Question:
What if there is a retreat of the same or adjacent area and the provider orders a special physics
consult 77370 for the additional work?
Answer:
Special Medical Radiation Physics Consultation
CPT® 77370 may be billed separately, for example, when a special physics assessment is needed during
the course of therapy. A medical physics consultation could also be appropriate where it applies to
another modality (e.g., an accompanying "boost" with external beam) but it may not be billed with CPT®
77301 if it is part of the plan development.
5
Question:
Is there a code for 2D radiation therapy?
Answer:
According to the American Medical Association (AMA) CPT® 2022, radiation treatment delivery with
conventional X-ray or electron beam is assigned levels of complexity based on the number of treatment
sites and complexity of the treatment fields, blocking, wedges, and physical or virtual tissue
compensators. CPT® codes for conventional external beam radiation treatment delivery range from
77401 – 77412. *Please be sure to check your payer policy for applicable G-codes.
6
Question:
Is there a training course for coders/auditors for Radiation Oncology?
Answer:
If you are looking for a specific program for Radiation Oncology, I would recommend the American
Society for Radiation Oncology (ASTRO). ASTRO has a program that offers courses, webinars, and
seminars that are amazing.
& Answers Latest Update
1
Question:
Complex Treatment Devices
Can 77334 TC and 26 be billed on different days?
Answer:
CMS has covered Complex Treatment Devices extensively under the Billing and Coding Guidelines.
2
Question:
There was a previous OIG report in which a complex simulation code was billed several days prior to the
IMRT planning code and it was considered unbundling. Is there a timeframe associated with the
unbundling of codes in relationship to the IMRT planning?
Answer:
CPT® codes 77280, 77285, and 77290 describe the process of defining relevant normal and abnormal
target anatomy and acquiring the images and data necessary to develop the optimal radiation treatment
process for the patient. These codes may be billed separately ithey are not a part of the IMRT treatment
plan and may not be billed with CPT® 77301.
3
Question:
What are the documentation requirements for 77334?
Answer:
CPT® code 77334 is for complex treatment devices, design, and construction that include customized,
single-use bolus, such as wax molds conformed to a particular patient body part; customized blocks (low
temperature alloy); customized compensators; wedges; molds or casts; custom-made immobilization
devices, or eye-shields. Custom-made immobilization include restraining devices such as aquaplast and
alpha cradle. The use of passive restraints such as straps, pillows, sandbags, etc. are not billable.
, 4
Question:
What if there is a retreat of the same or adjacent area and the provider orders a special physics
consult 77370 for the additional work?
Answer:
Special Medical Radiation Physics Consultation
CPT® 77370 may be billed separately, for example, when a special physics assessment is needed during
the course of therapy. A medical physics consultation could also be appropriate where it applies to
another modality (e.g., an accompanying "boost" with external beam) but it may not be billed with CPT®
77301 if it is part of the plan development.
5
Question:
Is there a code for 2D radiation therapy?
Answer:
According to the American Medical Association (AMA) CPT® 2022, radiation treatment delivery with
conventional X-ray or electron beam is assigned levels of complexity based on the number of treatment
sites and complexity of the treatment fields, blocking, wedges, and physical or virtual tissue
compensators. CPT® codes for conventional external beam radiation treatment delivery range from
77401 – 77412. *Please be sure to check your payer policy for applicable G-codes.
6
Question:
Is there a training course for coders/auditors for Radiation Oncology?
Answer:
If you are looking for a specific program for Radiation Oncology, I would recommend the American
Society for Radiation Oncology (ASTRO). ASTRO has a program that offers courses, webinars, and
seminars that are amazing.
