Reimbursement

 

Image guided radiation therapy and brachytherapy procedures using the HDR source are accepted treatment options for breast irradiation following lumpectomy. CMS has declared AccuBoost as a recognized brachytherapy procedure. Current Procedural Terminology (CPT) codes and descriptive terms provide general information and options for the services and procedures performed by physicians and medical physicists using the AccuBoost System.

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.

To offer appropriate guidelines to the providers, Advanced Radiation Therapy has received coding guidelines from InSearch Solutions, Inc. to help hospitals and physicians to secure appropriate coverage for the AccuBoost procedure. Click on the link below for a copy of the 2016 Coding Guide, a summary of which can be found below.

 

CPT code  Code Description
Treatment Planning
77014 CT for treatment planning (optional)
77263 Therapeutic radiology treatment planning, complex
77290 Simulation, complex
77295 Simulation, 3-Dimensional
77328 Isodose planning, complex
77370 Special medical physics consult
77470 Special treatment procedure
Brachytherapy Delivery
77317  Brachytherapy Isodose Planning (2-12 channels)
77332 Treatment device
77336 Weekly medical physics consult
19499 Unlisted breast procedure (application of catheter) by report
77280 Simulation, simple
77771 Remote Afterloading HDR
C1717 Radiation source (Ir-192)

Image guided radiation therapy and brachytherapy procedures using the HDR source are accepted treatment options for breast irradiation following lumpectomy. Current Procedural Terminology (CPT) codes and descriptive terms provide general information and options for the services and procedures performed by physicians and medical physicists using the AccuBoost System.