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81 Cards in this Set
- Front
- Back
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0073T
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Compensator-based beam modulation treatment delivery of inverse planned treatment using 3 or more high resolution (milled or cast) compensator convergent beam modulated fields, per treatment session
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0182T
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High dose rate electronic brachytherapy, per fraction
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0197T
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Intra-fraction localization and tracking of target or patient motion during delivery of radiation therapy (eg, 3D positional tracking, gating, 3D surface tracking), each fraction of treatment
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32553
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Placement of interstitial device(s) for radiation therapy guidance (eg, fiducial markers, dosimeter), percutaneous, intra-thoracic, single or multiple
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49411
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Placement of interstitial device(s) for radiation therapy guidance (eg, fiducial markers, dosimeter), percutaneous, intra-abdominal, intra-pelvic (except prostate), and/or retroperitoneum, single or multiple
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55875
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Transperineal placement of needles or catheters into prostate for interstitial radioelement application, with or without cystoscopy
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55876
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Placement of interstitial device(s) for radiation therapy guidance (eg, fiducial markers, dosimeter), prostate (via needle, any approach), single or multiple
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55920
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Placement of needles or catheters into pelvic organs and/or genitalia (except prostate) for subsequent interstitial radioelement application
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76950
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Ultrasonic guidance for placement of radiation therapy fields
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76965
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Ultrasonic guidance for interstitial radioelement application
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77011
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Computed tomography guidance for stereotactic localization
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77014
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Computed tomography guidance for placement of radiation therapy fields
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77261
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Therapeutic radiology treatment planning; simple
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77262
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Therapeutic radiology treatment planning; intermediate
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77263
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Therapeutic radiology treatment planning; complex
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77280
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Therapeutic radiology simulation-aided field setting; simple
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77285
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Therapeutic radiology simulation-aided field setting; intermediate
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77290
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Therapeutic radiology simulation-aided field setting; complex
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77295
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Therapeutic radiology simulation-aided field setting; 3-dimensional
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77299
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Unlisted procedure, therapeutic radiology clinical treatment planning
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77300
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Basic radiation dosimetry calculation, central axis depth dose calculation, TDF, NSD, gap calculation, off axis factor, tissue inhomogeneity factors, calculation of non-ionizing radiation surface and depth dose, as required during course of treatment, o
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77301
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Intensity modulated radiotherapy plan, including dose-volume histograms for target and critical structure partial tolerance specifications
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77305
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Teletherapy, isodose plan (whether hand or computer calculated); simple (1 or 2 parallel opposed unmodified ports directed to a single area of interest)
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77310
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Teletherapy, isodose plan (whether hand or computer calculated); intermediate (3 or more treatment ports directed to a single area of interest)
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77315
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Teletherapy, isodose plan (whether hand or computer calculated); complex (mantle or inverted Y, tangential ports, the use of wedges, compensators, complex blocking, rotational beam, or special beam considerations)
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77321
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Special teletherapy port plan, particles, hemibody, total body
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77326
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Brachytherapy isodose plan; simple (calculation made from single plane, 1 to 4 sources/ribbon application, remote afterloading brachytherapy, 1 to 8 sources)
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77327
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Brachytherapy isodose plan; intermediate (multiplane dosage calculations, application involving 5 to 10 sources/ribbons, remote afterloading brachytherapy, 9 to 12 sources)
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77328
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Brachytherapy isodose plan; complex (multiplane isodose plan, volume implant calculations, over 10 sources/ribbons used, special spatial reconstruction, remote afterloading brachytherapy, over 12 sources)
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77331
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Special dosimetry (eg, TLD, microdosimetry) (specify), only when prescribed by the treating physician
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77332
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Treatment devices, design and construction; simple (simple block, simple bolus)
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77333
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Treatment devices, design and construction; intermediate (multiple blocks, stents, bite blocks, special bolus)
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77334
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Treatment devices, design and construction; complex (irregular blocks, special shields, compensators, wedges, molds or casts)
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77336
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Continuing medical physics consultation, including assessment of treatment parameters, quality assurance of dose delivery, and review of patient treatment documentation in support of the radiation oncologist, reported per week of therapy
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77338
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Multi-leaf collimator (MLC) device(s) for intensity modulated radiation therapy (IMRT), design and construction per IMRT plan
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77370
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Special medical radiation physics consultation
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77371
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Radiation treatment delivery, stereotactic radiosurgery (SRS), complete course of treatment of cranial lesion(s) consisting of 1 session; multi-source Cobalt 60 based
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77372
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Radiation treatment delivery, stereotactic radiosurgery (SRS), complete course of treatment of cranial lesion(s) consisting of 1 session; linear accelerator based
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77373
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Stereotactic body radiation therapy, treatment delivery, per fraction to 1 or more lesions, including image guidance, entire course not to exceed 5 fractions
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77399
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Unlisted procedure, medical radiation physics, dosimetry and treatment devices, and special services
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77401
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Radiation treatment delivery, superficial and/or ortho voltage
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77402
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Radiation treatment delivery, single treatment area, single port or parallel opposed ports, simple blocks or no blocks; up to 5 MeV
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77403
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Radiation treatment delivery, single treatment area, single port or parallel opposed ports, simple blocks or no blocks; 6-10 MeV
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77404
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Radiation treatment delivery, single treatment area, single port or parallel opposed ports, simple blocks or no blocks; 11-19 MeV
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77406
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Radiation treatment delivery, single treatment area, single port or parallel opposed ports, simple blocks or no blocks; 20 MeV or greater
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77407
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Radiation treatment delivery, 2 separate treatment areas, 3 or more ports on a single treatment area, use of multiple blocks; up to 5 MeV
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77408
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Radiation treatment delivery, 2 separate treatment areas, 3 or more ports on a single treatment area, use of multiple blocks; 6-10 MeV
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77409
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Radiation treatment delivery, 2 separate treatment areas, 3 or more ports on a single treatment area, use of multiple blocks; 11-19 MeV
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77411
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Radiation treatment delivery, 2 separate treatment areas, 3 or more ports on a single treatment area, use of multiple blocks; 20 MeV or greater
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77412
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Radiation treatment delivery, 3 or more separate treatment areas, custom blocking, tangential ports, wedges, rotational beam, compensators, electron beam; up to 5 MeV
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77413
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Radiation treatment delivery, 3 or more separate treatment areas, custom blocking, tangential ports, wedges, rotational beam, compensators, electron beam; 6-10 MeV
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77414
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Radiation treatment delivery, 3 or more separate treatment areas, custom blocking, tangential ports, wedges, rotational beam, compensators, electron beam; 11-19 MeV
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77416
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Radiation treatment delivery, 3 or more separate treatment areas, custom blocking, tangential ports, wedges, rotational beam, compensators, electron beam; 20 MeV or greater
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77417
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Therapeutic radiology port film(s)
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77418
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Intensity modulated treatment delivery, single or multiple fields/arcs, via narrow spatially and temporally modulated beams, binary, dynamic MLC, per treatment session
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77421
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Stereoscopic X-ray guidance for localization of target volume for the delivery of radiation therapy
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77422
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High energy neutron radiation treatment delivery; single treatment area using a single port or parallel-opposed ports with no blocks or simple blocking
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77423
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High energy neutron radiation treatment delivery; 1 or more isocenter(s) with coplanar or non-coplanar geometry with blocking and/or wedge, and/or compensator(s)
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77427
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Radiation treatment management, 5 treatments
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77431
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Radiation therapy management with complete course of therapy consisting of 1 or 2 fractions only
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77432
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Stereotactic radiation treatment management of cranial lesion(s) (complete course of treatment consisting of 1 session)
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77435
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Stereotactic body radiation therapy, treatment management, per treatment course, to 1 or more lesions, including image guidance, entire course not to exceed 5 fractions
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77470
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Special treatment procedure (eg, total body irradiation, hemibody radiation, per oral, endocavitary or intraoperative cone irradiation)
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77499
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Unlisted procedure, therapeutic radiology treatment management
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77520
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Proton treatment delivery; simple, without compensation
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77522
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Proton treatment delivery; simple, with compensation
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77523
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Proton treatment delivery; intermediate
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77525
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Proton treatment delivery; complex
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77750
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Infusion or instillation of radioelement solution (includes 3-month follow-up care)
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77761
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Intracavitary radiation source application; simple
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77762
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Intracavitary radiation source application; intermediate
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77763
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Intracavitary radiation source application; complex
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77776
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Interstitial radiation source application; simple
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77777
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Interstitial radiation source application; intermediate
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77778
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Interstitial radiation source application; complex
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77785
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Remote afterloading high dose rate radionuclide brachytherapy; 1 channel
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77786
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Remote afterloading high dose rate radionuclide brachytherapy; 2-12 channels
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77787
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Remote afterloading high dose rate radionuclide brachytherapy; over 12 channels
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77789
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Surface application of radiation source
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77790
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Supervision, handling, loading of radiation source
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77799
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Unlisted procedure, clinical brachytherapy
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