2025 CPT code 77435
Effective Date: N/A Radiation Oncology Feed
Stereotactic body radiation therapy treatment management, per treatment course, to one or more lesions, including image guidance, entire course not to exceed 5 fractions.
Yes, applicable modifiers exist. Refer to the provided modifier list.
Medical necessity must be established for SBRT, which is typically used for small, well-defined tumors when conventional radiation therapy is not suitable.
In simple words: This procedure involves the doctor managing a highly precise radiation treatment called SBRT. The doctor uses advanced imaging to pinpoint the tumor(s) and delivers a few very strong doses of radiation to destroy them.The treatment is given in sessions called "fractions" and won't have more than five fractions. This code covers the doctor's work in overseeing and coordinating this specialized treatment.
This code represents the physician's management of a complete course of stereotactic body radiation therapy (SBRT) treatment. SBRT uses a three-dimensional coordinate system to precisely target and destroy lesions in the body (excluding the brain and spinal cord) with high doses of externally generated ionized radiation.The entire treatment course is limited to a maximum of five fractions and can target single or multiple lesions. The service includes image guidance, which is integral to SBRT treatment delivery. It also includes the professional component of guidance for localization of target volume for the delivery of radiation therapy.
Example 1: A patient with a small lung tumor receives a course of SBRT consisting of five fractions. Code 77435 is reported once for the physician’s management of the entire treatment course., A patient with multiple liver lesions undergoes SBRT treatment in three fractions. Code 77435 is reported once., A patient receives SBRT for a spinal tumor (not involving the spinal cord itself). The course consists of five fractions.Code 77435 is reported once.
Documentation should include details of the treatment plan, number of fractions, image guidance used, physician’s assessment of the patient's response to treatment, coordination of care, review of imaging/lab results, and review of port films, dosimetry, and treatment parameters.
** The provided information is current as of December 1st, 2024.Coding guidelines and regulations are subject to change.