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CODING GUIDELINES - eviCore

Radiation Therapy Effective January 1, 2018 CODING GUIDELINES for medical necessity review of radiation therapy services. 2018 eviCore healthcare. All rights reserved. CODING GUIDELINES Page 2 of 12 Please note the following: CPT Copyright 2017 American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association. Page 3 of 12 Please note the following: All information provided by the NCCN is Referenced with permission from the NCCN Clinical Practice GUIDELINES in Oncology (NCCN GuidelinesTM) 2018 National Comprehensive Cancer Network.

1. Contouring for three-dimensional conformal radiation therapy (3D-CRT) 2. Contouring for intensity modulated radiation therapy (IMRT), even when multiple image sets are referenced 3. Reviewing a multiphase plan when the physicist has done the work of - summing the plans. 4. The work required for the 4DCT performed during simulation for treatment

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