Reimbursement
AccuBoost Reimbursement Codes
Image-guided radiation therapy and HDR brachytherapy procedures are routine treatment options for breast irradiation. For the US market, CMS has declared AccuBoost as a recognized brachytherapy procedure. Current Procedural Terminology (CPT) codes and descriptive terms provide general information for the services and procedures performed by physicians and medical physicists when the AccuBoost Technique is offered.
The following information is for reference only and does not guarantee coverage or payment. Because coverage decisions vary across payers, healthcare providers should supply evidence that a treatment option is appropriate for the specified clinical condition. The commercial payers and CMS apply their own interpretation relating to coverage for devices and related hospital and physician services.
Advanced Radiation Therapy has received coding guidelines from firms skilled in such reviews to help hospitals and physicians to apply for appropriate coverage when AccuBoost Technique is offered.
View the following chart for a summary of potentially appropriate CPT codes or click the link below to download a Coding Guide.
CPT Codes
CPT Code | Code Description |
---|---|
Treatment Planning | |
77014 | CT for treatment planning (optional) |
77263 | Therapeutic radiology treatment planning, complex |
77290 | Simulation, complex |
77370 | Special medical physics consult |
77470 | Special treatment procedure |
Brachytherapy Delivery | |
77317 | Brachytherapy Isodose Planning (2-12 channels) |
77332 | Treatment device, simple |
77336 | Weekly medical physics consult |
77280 | Simulation, simple |
19499 | Unlisted Breast Procedure (application of catheter) Paid by report |
77290 | Simulation, complex |
77771 | Remote Afterloading HDR |
C1717 | Radiation source (lr-192) |