Coding Guidance - American Society for Radiation Oncology

1 Coding GuidanceM AY 2015 IMAGE GUIDED Radiation THERAPY IN 2015: CPT CODE 77387 Reminder to Hospitals:Report the technical component (TC) of IGRT when performed with conventional (non-IMRT, non-SRS/SBRT) Radiation treatment delivery. CPT code 77387 ( Guidance for localization of target volume for delivery of Radiation treatment delivery, includes intrafraction tracking, when performed) is a new code effective January 1, 2015, for use in the hospital setting. CONVENTIONAL Radiation THERAPY (CPT CODES 77402, 77407 AND 77412)CPT code 77387 has both a professional component (PC) and a technical component (TC). The TC of 77387 is not reimbursed separately in the hospital setting because it is packaged into the Ambulatory Payment Classification (APC) with the treatment delivery service with which it is performed. However, 77387-TC should always be reported when image Guidance is performed with conventional Radiation therapy (CPT codes 77402, 77407, and 77412).

2 This data is collected by CMS and is utilized in calculating future reimbursement values for IGRT under the Hospital Outpatient Prospective Payment System (HOPPS). Failure to report IGRT-TC when performed with conventional Radiation therapy may result in inappropriate reimbursement in future years. IGRT should not be billed in association with CPT code 77401, superficial/orthovoltage treatment MODULATED Radiation THERAPY (IMRT) (CPT CODES 77385 AND 77386)77387-TC should not be reported with IMRT delivery codes 77385 and 77386 because 77387-TC is bundled into the IMRT delivery codes. When IGRT is bundled, as with IMRT, the hospital should modify its chargemaster such that the IMRT delivery charges reflect the included IGRT work. IGRT-TC should not be separately billed or reported with IMRT; however, the professional component of IGRT can still be technical and professional reporting requirements for IGRT in the hospital setting are summarized in the table below.

3 2015 IGRT REPORTING IN THE HOSPITAL SETTINGIGRT in Conventional Radiation Treatment Delivery Hospital bills Treatment delivery code: 77402, 77407 or 77412 Physician bills IGRT code: G6001, G6002, and/or 77014 with -26 modifier (PC)Note: When performing conventional treatment delivery with IGRT, 77387-TC is not separately reimbursable. However, it is extremely important to report 77387-TC separately for tracking purposes and non-HOPPS payers. IGRT in IMRT DeliveryHospital bills IMRT code: 77385 or 77386 Physician bills IGRT code: G6001, G6002, and/or 77014 with -26 modifier (PC)Note: Hospitals should modify their chargemasters to include IGRT within the IMRT delivery charge. However, do not bill or report IGRT-TC separately with IMRT. CPT Copyright 2014 American Medical Association. All rights reserved.