In simple words: During surgery, the doctor manages the radiation treatment delivered directly to the tumor.This includes checking the patient's response, coordinating care, reviewing images and lab results, and ensuring the radiation is delivered accurately and safely.

This code represents the management of intraoperative radiation treatment, where radiation therapy is administered directly to the exposed tumor during surgery.The physician's services include at least one examination of the patient for medical evaluation and management during the intraoperative session (e.g., assessment of the patient's response to treatment, coordination of care and treatment, review of imaging and/or lab test results with documentation), review of port images, dosimetry, dose delivery, and treatment parameters, and review of patient treatment set-up.

Example 1: A patient undergoes surgery for a locally advanced rectal cancer. To target any remaining cancer cells after surgical removal, the radiation oncologist administers intraoperative radiation therapy and manages the treatment delivery during the procedure., A patient with a soft tissue sarcoma of the extremity undergoes surgery. Due to the tumor's proximity to critical structures, intraoperative radiation is used to deliver a high dose to the tumor bed while minimizing exposure to surrounding tissues. Code 77469 is reported for the radiation oncologist's management of the radiation treatment during the procedure., During a breast-conserving surgery for early-stage breast cancer, IORT is administered after the removal of the tumor to target any microscopic residual disease. The radiation oncologist's management of the IORT is reported with 77469.

Documentation should include details of the intraoperative radiation treatment plan, including the dose delivered, the target area, and the methods used to protect surrounding tissues. The physician's examination of the patient, review of imaging and treatment parameters, and coordination of care should also be documented.