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BETA v.3.0

2025 CPT code 77387

Guidance for localization of target volume for delivery of radiation treatment, includes intrafraction tracking, when performed.

This code includes intrafraction tracking.It should not be reported with IMRT delivery codes (77385, 77386) and only the technical component is included.

Modifier 26 can be applied for the professional component. Modifier TC can be used to indicate the technical component.

Medical necessity for image guidance is established when its use is essential for accurate and safe delivery of radiation therapy. This may be due to tumor location, movement, or proximity to critical structures. Documentation should support the clinical rationale for its use.

The physician is responsible for identifying the targeted tumor site before initiating radiotherapy. This involves using imaging to ensure precise radiation delivery and minimize exposure to healthy tissues. The physician analyzes the image and adjusts the radiation targeting as needed.

In simple words: The doctor uses imaging technology like x-rays or ultrasound to precisely target the tumor during radiation therapy. This helps to protect the healthy tissues around the tumor. The process also includes tracking the tumor's position during the treatment to maintain accuracy.

This code represents the use of imaging guidance to pinpoint the exact location of the tumor for radiation therapy. It includes real-time tracking during treatment to ensure accuracy and minimize damage to surrounding healthy tissues. The imaging technique may involve X-rays, computed tomography (CT), ultrasound, or other methods.This code does not include the professional component of physician involvement in guidance or tracking and should not be reported with IMRT delivery codes (77385, 77386) as the technical component is already included in those codes.

Example 1: A patient with prostate cancer undergoes radiation therapy, and CT imaging is used to guide the radiation beam and adjust for movement during treatment., A patient receiving radiation for a lung tumor has ultrasound imaging used to track the tumor's position throughout the treatment session., A patient with breast cancer undergoes radiation therapy with real-time tracking of the tumor using stereoscopic imaging to ensure accurate delivery.

Documentation should include the type of imaging guidance used, the target volume specifications, and any adjustments made during treatment.Records must also confirm the medical necessity of the guidance procedure and detail the treatment plan.

** For conventional treatment delivery with IGRT, 77387-TC is generally not separately reimbursed by HOPPS payers. However, it's important to report it for tracking purposes and non-HOPPS payers.

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