May 19, 2006
| Article for Correct Billing Procedure for Temporary CPT Code 0083T Stereotactic Body Radiation Therapy, Treatment Management (A40119) |
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| Contractor Information |
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| Contractor Name back to top |
| CIGNA Government Services |
| Contractor Number back to top |
| 05440 |
| Contractor Type back to top |
| Carrier |
| Article Information |
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| Article ID Number back to top |
| A40116 |
| Article Type back to top |
| Article |
| Key Article back to top |
| No |
| Article Title back to top |
| Correct Billing Procedure for Temporary CPT Code 0083T Stereotactic Body Radiation Therapy, Treatment Management |
| AMA CPT / ADA CDT Copyright Statement back to top |
| CPT codes, descriptions and other data only are copyright 2005 American Medical Association (or such other date of publication of CPT). All Rights Reserved. Applicable FARS/DFARS Clauses Apply. Current Dental Terminology, (CDT) (including procedure codes, nomenclature, descriptors and other data contained therein) is copyright by the American Dental Association. © 2002, 2004 American Dental Association. All rights reserved. Applicable FARS/DFARS apply. |
| Primary Geographic Jurisdiction back to top |
| Tennessee |
| Original Article Effective Date back to top |
| 05/01/2006 |
| Article Revision Effective Date back to top |
| Article Text back to top |
| Stereotactic body radiation therapy (SBRT)
is a method of delivering large single radiation doses or a limited
numbers of radiation fractions (hypofractionated radiotherapy) to
small target volumes within major visceral organs such as the lung
and liver. SBRT targets a tumor from many different directions so
that the beams of radiation converge on the tumor. No actual
incision is made in SBRT. The goal of SBRT is to deliver enough
radiation to destroy or stop the growth of a lesion without
adversely affecting surrounding tissue. Normal tissues are protected
both by selectively targeting only the abnormal lesion and by using
crossfiring techniques to minimize the exposure of the adjacent
anatomy. In that way, the amount of radiation needed to destroy
tumor cells is delivered directly to the neoplasm, and the amount of
exposure to the area surrounding the tumor is limited. With SBRT
high doses of radiation can be delivered with submillimeter
accuracy. Stereotactic Body Radiation Therapy, Treatment Management, Per Day should be reported using the Temporary CPT Code 0083T. CMS has designated that Temporary CPT Code 0083T be carrier priced at this time. In an effort to arrive at an equitable payment rate, the RVU's involved were reviewed and consultation was undertaken with leaders in this field. CIGNA Government Services has determined that the payment rates for 0083T are as follows until further notice: 1. Day one of therapy will be paid at the current rate for CPT Code 77432. 2. All subsequent days of therapy will be paid at the current rate for CPT 77431. 3. This policy does not take precedence over CCI edits. Please refer to CCI for correct coding guidelines and specific applicable code combinations prior to billing Medicare. All such documentation as is necessary to determine medical necessity for the use of this modality over other current treatment modalities should be maintained in the patient's medical record and readily available for review by CMS, CIGNA Government Services or other CMS authorized carriers including but not limited to the Program Safeguard Carrier and the CERT Carrier. |
| Coverage Topic back to top |
| Radiation Therapy (Outpatient) |
| Coding Information |
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| No Coding Information has been entered in this section of the article. |
| Other Information |
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| There is no Other Information for this article. |
