2025 CPT code 77407
(Active) Effective Date: N/A Revision Date: N/A Radiation Treatment Delivery - Radiation Oncology Treatment Radiology Feed
This code represents the technical component of intermediate-level radiation treatment delivery using ≥1 MeV energy, involving multiple treatment areas, ports, and blocks.
Modifiers may apply depending on the specific circumstances of the service, such as 59 (distinct procedural service) or 76 (repeat procedure by the same physician). Consult the CPT manual and payer-specific guidelines.
Medical necessity for code 77407 is established through the presence of a diagnosed malignancy or other condition requiring external beam radiation therapy.The treatment plan must be medically appropriate and justified by the patient’s clinical presentation, and the documented justification of the intermediate complexity level is needed.
The clinical responsibility for code 77407 rests with the radiation therapist who operates the linear accelerator and delivers the prescribed radiation dose to the patient.This involves precise positioning of the patient, accurate setup of the radiation beam parameters (energy, field size, etc.), and monitoring the treatment delivery process to ensure the intended dose is delivered safely and effectively. The physician's role is in planning and managing the treatment, not in the technical execution covered by this code.
In simple words: This code is for the technical part of giving a medium-level radiation treatment.The treatment uses a high-energy beam to target cancer. It's considered "intermediate" because it involves multiple areas being treated or complex setups.
CPT code 77407 describes the technical component of intermediate-level radiation treatment delivery.It applies to treatments using a radiation beam with an energy level of greater than or equal to 1 MeV. The intermediate complexity level is defined by any of the following criteria: two or more separate treatment areas; three or more ports on a single treatment area; or three or more simple blocks.The code encompasses the technical aspects of delivering the radiation, excluding the physician's professional component.This code does not include image-guided radiation therapy (IGRT); if IGRT is used, the technical component is bundled into the code, but the professional component must be billed separately using 77387-PC.
Example 1: A patient with lung cancer requiring radiation therapy to two separate lung lobes, each requiring three treatment ports and multiple blocks to shield healthy lung tissue. , A patient with head and neck cancer needing radiation to multiple lymph nodes in the neck, utilizing several treatment fields and several blocks for critical organ protection (spinal cord, salivary glands, etc.)., A patient with pelvic cancer requiring radiation to the pelvic region with the use of multiple radiation fields and complex shielding to protect the bowel and bladder from radiation exposure.
Comprehensive documentation is required and should include:* Physician's orders specifying the treatment plan, including number of treatment areas, ports, and blocks.* Treatment plan outlining the intended dose, energy level, and other relevant parameters.* Detailed records of each treatment session, documenting patient positioning, beam setup, and dosimetry information.* Imaging studies (if used) to guide treatment and verify target localization.
** The selection of 77407 depends on the specific clinical scenario and should be supported by thorough documentation of the treatment complexity.Always refer to the most current CPT and payer guidelines for accurate coding.
- Revenue Code: P7A (ONCOLOGY - RADIATION THERAPY)
- Payment Status: Active
- Modifier TC rule: The technical component (TC) is the primary component of this code.No additional modifier is needed to indicate the technical component.
- Specialties:Radiation Oncology
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center