2025 CPT code 77767
(Active) Effective Date: N/A Revision Date: N/A Radiology Procedures - Clinical Brachytherapy Radiation Treatment Radiation Oncology Feed
Remote afterloading high dose rate radionuclide skin surface brachytherapy for lesions up to 2.0 cm or using a single channel; includes basic dosimetry.
Modifiers 26 (professional component) and TC (technical component) may be appended to 77767 depending on the services rendered and who provides them. Other modifiers may be necessary depending on the clinical circumstance and payer requirements.
Medical necessity for 77767 is established by the presence of a suitable skin lesion (e.g., basal cell carcinoma, squamous cell carcinoma) that is appropriate for treatment with HDR brachytherapy. The lesion size should be ≤ 2.0 cm, or treatment with a single channel is appropriate. Documentation should clearly show the lesion's characteristics and support the decision for HDR brachytherapy as a medically necessary treatment modality.
The therapeutic radiologist is responsible for the supervision of radioelements, dose interpretation, and treatment planning. The clinical responsibility includes the placement of the applicator or catheter and the remote loading of the radioactive material.If a surgeon assists in placement, modifier 80 may be appropriate.
In simple words: This code describes a type of radiation therapy for skin tumors up to 2 centimeters across, or those treated with a single radiation source near the skin. The radiation is precisely targeted to the tumor, minimizing exposure to healthy tissue. The machine that delivers the radiation is remotely controlled for safety.
This CPT code encompasses remote afterloading high dose rate radionuclide skin surface brachytherapy.The procedure involves delivering a high dose of radiation to a skin lesion with a diameter of up to 2.0 cm, or utilizing a single channel applicator placed directly on or near the skin surface.Basic dosimetry calculations are included in this code.The procedure is characterized by the use of a remote afterloader to minimize radiation exposure to healthcare personnel.
Example 1: A 65-year-old male presents with a 1.8 cm basal cell carcinoma on his nose.After simulation and planning, remote afterloading HDR brachytherapy is performed using a single channel applicator. Code 77767 is reported., A 78-year-old female presents with a superficial 1.5 cm squamous cell carcinoma on her cheek.HDR brachytherapy using a single channel applicator is performed. Code 77767 is reported., An 80-year-old male presents with multiple small skin lesions consistent with Bowen's disease. One 1cm lesion on the forearm is treated with HDR brachytherapy using a single channel applicator. Code 77767 is reported for this single lesion. Additional lesions require separate coding if treated.
Complete medical history, physical examination findings, pathology report confirming the diagnosis, images (e.g., photographs, dermatoscopy images) documenting the lesion's size and location, treatment plan outlining the dose and technique, and the radiation physicist's report verifying the dosimetry calculations are essential. Documentation of the remotely controlled afterloading device and its settings should also be included.
** This code specifically applies to remote afterloading HDR brachytherapy.Ensure proper documentation supports the use of this specific technique and lesion size.Always refer to the most current CPT manual and payer guidelines for accurate coding and reimbursement.
- Revenue Code: P7A (ONCOLOGY - RADIATION THERAPY)
- RVU: This information is not available in the provided sources.RVUs vary by payer and location. Consult your local fee schedule.
- Global Days: The global period is not specified for this code.Consult your payer's guidelines for details.
- Payment Status: Active
- Modifier TC rule: Modifier TC (Technical Component) may apply if the technical aspects of the procedure, such as equipment and staff, are provided separately from the physician's professional services.However, certain payers may not require modifier TC from hospitals.
- Fee Schedule: This information is not available in the provided sources.Consult historical fee schedules for specific data.
- Specialties:Radiation Oncology, Dermatology
- Place of Service:Office, Outpatient Hospital, Ambulatory Surgical Center