2025 CPT code 77301
(Active) Effective Date: N/A Revision Date: N/A Radiology - Radiation Oncology Treatment Planning Radiology Procedures > Radiation Oncology Treatment Feed
Intensity-modulated radiotherapy (IMRT) plan creation, incorporating dose-volume histograms for target and critical structures, and partial tolerance specifications.The plan uses inverse or forward planning with modulated beam delivery.
Modifiers 26 (professional component), 59 (distinct procedural service), and others may be applicable based on specific circumstances. Refer to the CPT manual for modifier usage guidelines.
Medical necessity for IMRT is established when it is deemed the most appropriate treatment option for a specific cancer based on tumor location, size, proximity to critical structures, and overall patient health. The decision is supported by the physician's clinical judgment, evidence-based guidelines, and documented patient-specific factors.
The radiation oncologist is responsible for developing the IMRT treatment plan, which involves considering tumor location, surrounding organs at risk, the prescribed dose, and the number and angles of radiation beams. The physician optimizes the plan using advanced software and techniques to maximize tumor coverage while minimizing damage to healthy tissue. They must also verify the plan's accuracy.
In simple words: This code covers the detailed planning for a type of radiation therapy called IMRT.A specialist uses a computer to create a precise plan to target cancer cells while protecting healthy tissue.The plan includes a detailed map showing where the radiation will go and how much will be given.
This CPT code encompasses the creation of an intensity-modulated radiotherapy (IMRT) plan.The plan utilizes inverse or forward planning techniques and modulated beam delivery (e.g., binary, dynamic MLC) to generate a highly conformal dose distribution.The process includes generating dose-volume histograms for the target and critical structures, specifying partial tolerance, and verifying the computer plan's positional accuracy through dosimetric verification of the intensity map, treatment setup verification, and interpretation of the verification methodology.
Example 1: A 65-year-old male patient diagnosed with prostate cancer undergoes IMRT treatment planning. The physician meticulously plans the treatment considering the proximity of the rectum and bladder to the prostate. The plan includes multiple beams with varying intensities and angles, optimized to maximize tumor dose while sparing the surrounding critical organs.Dose-volume histograms (DVHs) are generated to assess the radiation dose distribution to the tumor and organs at risk., A 48-year-old female patient with locally advanced breast cancer receives IMRT treatment planning.The physician uses advanced software to create an IMRT plan to target the tumor while minimizing radiation exposure to the heart and lungs.The plan is meticulously designed to achieve optimal dose coverage of the tumor, and the DVHs are analyzed to ensure that the organs at risk are adequately spared., A 72-year-old male patient with head and neck cancer undergoes IMRT planning.Due to the complex anatomy and proximity of several critical structures (spinal cord, brain stem, parotid glands), the physician carefully designs the treatment plan to achieve conformal dose distribution to the tumor while minimizing the risk of side effects to the surrounding organs. This case might involve more complex inverse planning algorithms and meticulous quality assurance.
* Detailed tumor location and size (imaging studies)* Location and delineation of organs at risk (OARs) on imaging* Prescribed dose and fractionation schedule* Treatment planning software used* Dose-volume histograms (DVHs) for target and OARs* Verification of treatment plan accuracy using dosimetry* Physician's notes outlining the treatment plan rationale and justification
** The provided information focuses on the planning aspect of IMRT.Separate codes would be used for the actual delivery of radiation therapy.Always refer to the latest CPT codebook and relevant payer guidelines for accurate coding and billing.
- Revenue Code: P7A (ONCOLOGY - RADIATION THERAPY)
- RVU: RVU data is not included in the provided text.Consult current Medicare fee schedules and other relevant payment databases for the most up-to-date RVU values.
- Global Days: The global period for this procedure is not specified in the provided text.Consult the specific payer's guidelines for details on global periods.
- Payment Status: Active
- Modifier TC rule: The TC (technical component) modifier is not typically applicable to this code as it is a professional service.
- Fee Schedule: Historical fee schedule data is not available in the provided text. Refer to past Medicare fee schedules and other relevant payment databases for historical fee information.
- Specialties:Radiation Oncology
- Place of Service:Office, Outpatient Hospital, Ambulatory Surgical Center