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2025 CPT code 77402

Radiation treatment delivery using ≥ 1 MeV energy; simple.

Refer to the most current CPT® manual and the American College of Radiology (ACR) Appropriateness Criteria for detailed coding guidelines.

Modifiers may be applicable depending on the circumstances of service. Consult your payer’s specific guidelines.

Medical necessity for radiation treatment is determined by the presence of a cancerous tumor or other condition requiring radiation therapy.Documentation must support the need for radiation therapy, including the tumor's location, size, and stage.Medical necessity is determined by the physician, not the coder.

The clinical responsibility for this code lies with the radiation oncologist or qualified radiation therapist who oversees the treatment planning and delivery of the radiation.The physician is responsible for the medical management of the patient but does not directly bill for the technical component of this code.

IMPORTANT Do not report 77402 with 77373 (SBRT, 1 or more lesions, 1-5 fractions).

In simple words: This code covers the technical part of giving radiation treatment to one area of the body using a high-energy beam.It's a simple treatment involving one or two entry points for the radiation and possibly some shielding to protect healthy tissue.

CPT code 77402 represents the technical component of external beam radiation therapy to a single treatment area with one or two ports and a maximum of two simple blocks.The energy used must be greater than or equal to 1 MeV.This code does not include the professional component (physician services).

Example 1: A patient with prostate cancer receives simple external beam radiation therapy to the prostate bed. The treatment involves a single treatment area, two opposing ports, and no blocks. Code 77402 is reported for each treatment session., A patient with breast cancer undergoes external beam radiation to the breast. Treatment includes a single area, one port, and one simple block to shield the heart.Code 77402 is billed for each treatment session., A patient with skin cancer receives superficial radiation therapy to a single lesion on the arm. The treatment involves a single area, one port, and no blocks. Code 77402 is reported for each treatment session, given the radiation energy is greater than or equal to 1 MeV.

* Detailed treatment plan outlining the number of treatment areas, ports, and blocks.* Documentation of radiation energy levels used (≥ 1 MeV).* Images (e.g., CT scan) demonstrating the treatment area and field setup.* Records of each treatment session, including date, time, and delivered dose.

** Ensure accurate documentation of the treatment plan, energy used, and number of treatment sessions is crucial for proper coding and billing.Always consult the current CPT® manual and payer-specific guidelines for the most up-to-date information.

** Only Enterprise users with EHR integration can access case-specific answers. Click here to request access.

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