How Should I Code This?: Guidelines for Coding Radiation Therapy Treatments

Jan. 13, 2017

Wilson Apollo gave an excellent presentation at the 2016 NCRA meeting assisting CTRs in coding radiation therapy.  This has been a much needed educational experience in our field as registrars and Radiation Oncologists are not always on the same page when it comes to correct coding. Below, we have some highlights from the presentation.

  • IMRT not always mentioned in RT Treatment Summary. Important to look in Treatment Plan. If IMRT and beam energy mentioned in treatment summary, code to IMRT, 31.

Treatment modalities that get IMRT code 31.

SBRT – Stereotactic body radiation therapy (a form of SRS)

  • SBRT in itself does not have its own code. It is the modality used in an SBRT plan that gets coded. 41 or 42, depending on the mode of delivery. If delivered with a linac, code 42. Otherwise, code 41, SRS, NOS.

 

Gamma Knife is used for the delivery of SRS treatment for brain lesions.

  • Gamma Knife should be coded 43.

 

Cyberknife is a form of Stereotactic Radiosurgery (SRS) delivered by a 6 MV linac.

  • Cyberknife is coded 42, Linac Radiosurgery.

 

SIRT -Selective Internal RT is also known as Selective Internal Irradiation (SIR).

  • Utilizes yttrium-90 microspheres for the txt of hepatocellular carcinoma (HCC).
  • Selective Internal RT with the use of Sir Spheres (yttrium-90), or Theraspheres, is considered radioembolization and coded 50 (Brachytherapy, NOS).

 

Brachytherapy for gyn cancers

  • Keep in mind that EBRT can also be prescribed as 1st course tx (40-45 Gy), in addition to brachytherapy. Code the brachytherapy as boost if EBRT is also administered.
  • Remember to enter 88888 for Radiation, Boost Dose for brachytherapy tx.
  • Code brachy procedure based on whether it is intracavitary vs. interstitial, and LDR vs. HDR. (50-54)

 

APBR – Accelerated partial breast irradiation

  • Form of localized brachytherapy tx for breast cancer pts; reduces the tx time significantly from the typical standard time of 5-6 weeks.

Accelerated partial breast irradiation

Guidelines for Coding Radiation Therapy Treatments

Wilson Apollo, MS, CTR, RTT        Presented at NCRA April 11, 2016

*The article is part of the Registry Partners Oncology QC Newsletter- Fall 2016 Edition.  Follow the blog to read more articles from the Newsletter or contact us to receive a copy of the full newsletter to share with your team!