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2025 CPT code 77295

3-dimensional radiotherapy plan, including dose-volume histograms.

CPT code 77295 should be reported once per treatment course, regardless of the number of treatment areas or the complexity of the plan. This code is used for 3D conformal radiotherapy, IMRT, and stereotactic radiosurgery plans.

Modifiers may be applicable in certain situations, such as reduced services (modifier 52) or discontinued procedures (modifier 53).

Medical necessity must be established for 3D radiotherapy planning. This requires demonstrating that the patient's condition is appropriate for radiation therapy and that the complexity of the case necessitates a 3D plan to ensure treatment efficacy and safety.

The radiation oncologist is responsible for overseeing the entire 3D radiotherapy planning process. This includes reviewing patient imaging data, defining target volumes and organs at risk, working with medical physicists and dosimetrists to optimize the radiation dose distribution, and approving the final treatment plan.

In simple words: This code covers the creation of a personalized 3D radiation therapy plan. Doctors use special computer software and imaging scans to map out the exact location and shape of the tumor. This helps them aim the radiation beams precisely at the tumor while avoiding damage to healthy tissues. The plan also includes graphs called dose-volume histograms, which show how much radiation different parts of the body will receive.

This code represents the planning and creation of a complex, three-dimensional radiation treatment plan, utilizing advanced imaging and computer-aided calculations to target tumors precisely while minimizing exposure to surrounding healthy tissues. The process includes defining target volumes (gross tumor volume, clinical target volume, and planning target volume), identifying organs at risk, and calculating dose distributions to optimize treatment efficacy and safety. Dose-volume histograms, which graphically summarize the radiation dose received by different volumes of tissue, are a key component of this planning process.

Example 1: A patient with prostate cancer undergoes a CT simulation, and a 3D radiotherapy plan, including dose-volume histograms (77295), is generated to guide the delivery of intensity-modulated radiation therapy (IMRT)., A patient with lung cancer undergoes a PET/CT scan for staging and treatment planning. The radiation oncologist uses the imaging data to develop a 3D conformal radiotherapy plan (77295) to precisely target the tumor while sparing surrounding healthy lung tissue., A patient with a brain tumor is treated with stereotactic radiosurgery. Prior to treatment, a 3D radiotherapy plan (77295) is created using MRI images to precisely target the tumor with high doses of radiation while minimizing exposure to surrounding brain tissue.

Documentation should include a detailed report of the 3D radiotherapy planning process, including the target volumes, organs at risk, dose calculations, dose-volume histograms, and rationale for the chosen treatment plan.

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