Procedure codes
77301 INTENSITY MODULATED RADIOTHERAPY PLAN, INCLUDING DOSE-VOLUME HISTOGRAMS FOR TARGET AND CRITICAL STRUCTURE PARTIAL TOLERANCE SPECIFICATIONS
77338 MULTI-LEAF COLLIMATOR (MLC) DEVICE(S) FOR INTENSITY MODULATED RADIATION THERAPY (IMRT), DESIGN AND CONSTRUCTION PER IMRT PLAN
77385 INTENSITY MODULATED RADIATION TREATMENT DELIVERY (IMRT), INCLUDES GUIDANCE AND TRACKING, WHEN PERFORMED; SIMPLE
77386 INTENSITY MODULATED RADIATION TREATMENT DELIVERY (IMRT), INCLUDES GUIDANCE AND TRACKING, WHEN PERFORMED; COMPLEX
G6015 INTENSITY MODULATED TREATMENT DELIVERY, SINGLE OR MULTIPLE FIELDS/ARCS,VIA NARROW SPATIALLY AND TEMPORALLY MODULATED BEAMS, BINARY, DYNAMIC MLC, PER TREATMENT SESSION
G6016 COMPENSATOR-BASED BEAM MODULATION TREATMENT DELIVERY OF INVERSE PLANNED TREATMENT USING 3 OR MORE HIGH RESOLUTION (MILLED OR CAST) COMPENSATOR, CONVERGENT BEAM MODULATED FIELDS, PER TREATMENT SESSION
Indications
IMRT is clinically indicated when highly conformal dose planning is required. IMRT planning may be clinically indicated when one or more of the following conditions are present:
An immediately adjacent area has been previously irradiated and abutting portals must be established with high precision.
Dose escalation is planned to deliver radiation doses in excess of those commonly utilized for similar tumors with conventional treatment.
The target volume is concave or convex, and the critical normal tissues are within or around that convexity or concavity.
The target volume is in close proximity to critical structures that must be protected.
The volume of interest must be covered with narrow margins to adequately protect immediately adjacent structures. According to the coding guide (ASTRO, 2015), the most common sites that currently support the use of IMRT include:
Carcinoma of the prostate
Primary, metastatic or benign tumors of the central nervous system, including the brain, brain stem, and spinal cord.
Primary, metastatic tumors of the spine where spinal cord tolerance may be exceeded by conventional treatment.
Primary, metastatic or benign lesions to the head and neck area, including:
Aerodigestive tract
Orbits
Salivary glands
Sinuses
Skull base
Re-irradiation that meets the requirements for medical necessity (as noted above).
Selected cases of thoracic and abdominal malignancies
Selected cases (i.e., not routine) of breast cancers with close proximity to critical structures
Other pelvic and retroperitoneal tumors that meet requirements for medical necessity (as noted above).
IMRT may be necessary in lung cancer cases involving bilateral mediastinal involvement, extension to the midline of the mediastinum, cardiac involvement, or tumor abutting or involving vertebrae or brachial plexus, or great vessels.
Although not routinely indicated in breast cancer, IMRT may be necessary when more than 2 gantry angles are required to meet dose constraints or when internal mammary nodes must be treated. IMRT is also indicated in pancreatic cancer, anal cancer and for postoperative use in endometrial, cervical and advanced rectal cancer.
Limitations
IMRT is not considered reasonable and necessary when at least one of the criteria listed in the section Indications and/or one of the diagnoses listed in the section ICD-10-CM Codes that Support Medical Necessity section of this policy are not present.
Compliance with the provisions in this policy is subject to monitoring by post payment data analysis and subsequent medical review.
- Use of published studies on organ movement when developing the PTV.
- Image-guided adaptive radiotherapy (e.g., ultrasound-guided or portal-image-guided setup with implanted fiducial markers).
- Respiratory gating of diaphragm movement for thoracic and upper abdominal sites.
- Important dose limiting structures adjacent to, but outside the PTV, are sufficiently close and require IMRT to assure safety and morbidity reduction.
- An immediately adjacent volume has been irradiated and abutting portals must be established with high precision.
- GTV margins are concave or convex and in close proximity to critical structures that must be protected to avoid unacceptable morbidity.
- Only IMRT techniques would decrease the probability of grade 2 or grade 3 radiation toxicity as compared to conventional radiation in greater than 15 percent of radiated similar cases.
- Safe and effective.
- Not experimental or investigational (exception: routine costs of qualifying clinical trial services with dates of service on or after September 19, 2000, which meet the requirements of the clinical trials NCD are considered reasonable and necessary).
- Appropriate, including the duration and frequency that is considered appropriate for the service, in terms of whether it is:
- Furnished in accordance with accepted standards of medical practice for the diagnosis or treatment of the patient’s condition or to improve the function of a malformed body member.
- Furnished in a setting appropriate to the patient’s medical needs and condition.
- Ordered and furnished by qualified personnel.
- One that meets, but does not exceed, the patient’s medical need.
- At least as beneficial as an existing and available medically appropriate alternative.
Providers are reminded to refer to the long descriptors of the CPT codes in their CPT book. The American Medical Association (AMA) and the Centers for Medicare & Medicaid Services (CMS) require the use of short CPT descriptors in policies published on the Web.
0073T Delivery, comp imrt
77301 Radiotherapy dose plan, imrt
77338 Design mlc device for imrt
77418 Radiation tx delivery, imrt
C00.0 – C00.8 – Opens in a new window Malignant neoplasm of external upper lip – Malignant neoplasm of overlapping sites of lip
C01 Malignant neoplasm of base of tongue
C02.0 – C02.8 – Opens in a new window Malignant neoplasm of dorsal surface of tongue – Malignant neoplasm of overlapping sites of tongue
C04.0 – C04.8 – Opens in a new window Malignant neoplasm of anterior floor of mouth – Malignant neoplasm of overlapping sites of floor of mouth
C05.0 – C05.8 – Opens in a new window Malignant neoplasm of hard palate – Malignant neoplasm of overlapping sites of palate
C06.0 – C06.89 – Opens in a new window Malignant neoplasm of cheek mucosa – Malignant neoplasm of overlapping sites of other parts of mouth
C07 Malignant neoplasm of parotid gland
C08.0 – C08.1 – Opens in a new window Malignant neoplasm of submandibular gland – Malignant neoplasm of sublingual gland
C09.0 – C09.8 – Opens in a new window Malignant neoplasm of tonsillar fossa – Malignant neoplasm of overlapping sites of tonsil
C10.0 – C10.8 – Opens in a new window Malignant neoplasm of vallecula – Malignant neoplasm of overlapping sites of oropharynx
C11.0 – C11.8 – Opens in a new window Malignant neoplasm of superior wall of nasopharynx – Malignant neoplasm of overlapping sites of nasopharynx
C12 Malignant neoplasm of pyriform sinus
C13.0 – C13.8 – Opens in a new window Malignant neoplasm of postcricoid region – Malignant neoplasm of overlapping sites of hypopharynx
C14.0 – C14.8 – Opens in a new window Malignant neoplasm of pharynx, unspecified – Malignant neoplasm of overlapping sites of lip, oral cavity and pharynx
C15.3 – C15.8 – Opens in a new window Malignant neoplasm of upper third of esophagus – Malignant neoplasm of overlapping sites of esophagus
C16.0 – C16.8 – Opens in a new window Malignant neoplasm of cardia – Malignant neoplasm of overlapping sites of stomach
C18.0 – C18.8 – Opens in a new window Malignant neoplasm of cecum – Malignant neoplasm of overlapping sites of colon
C19 Malignant neoplasm of rectosigmoid junction
C20 Malignant neoplasm of rectum
C21.0 – C21.8 – Opens in a new window Malignant neoplasm of anus, unspecified – Malignant neoplasm of overlapping sites of rectum, anus and anal canal
C22.0 – C22.9 – Opens in a new window Liver cell carcinoma – Malignant neoplasm of liver, not specified as primary or secondary
C23 Malignant neoplasm of gallbladder
C24.0 – C24.8 – Opens in a new window Malignant neoplasm of extrahepatic bile duct – Malignant neoplasm of overlapping sites of biliary tract
C25.0 – C25.8 – Opens in a new window Malignant neoplasm of head of pancreas – Malignant neoplasm of overlapping sites of pancreas
C30.0 – C30.1 – Opens in a new window Malignant neoplasm of nasal cavity – Malignant neoplasm of middle ear
C31.0 – C31.8 – Opens in a new window Malignant neoplasm of maxillary sinus – Malignant neoplasm of overlapping sites of accessory sinuses
C32.0 – C32.8 – Opens in a new window Malignant neoplasm of glottis – Malignant neoplasm of overlapping sites of larynx
C34.00 – C34.92 – Opens in a new window Malignant neoplasm of unspecified main bronchus – Malignant neoplasm of unspecified part of left bronchus or lung
C37 Malignant neoplasm of thymus
C38.0 – C38.8 – Opens in a new window Malignant neoplasm of heart – Malignant neoplasm of overlapping sites of heart, mediastinum and pleura
C40.00 – C40.80 – Opens in a new window Malignant neoplasm of scapula and long bones of unspecified upper limb – Malignant neoplasm of overlapping sites of bone and articular cartilage of unspecified limb
C41.0 – C41.4 – Opens in a new window Malignant neoplasm of bones of skull and face – Malignant neoplasm of pelvic bones, sacrum and coccyx
C45.1 Mesothelioma of peritoneum
C47.0 Malignant neoplasm of peripheral nerves of head, face and neck
C47.11 – C47.12 – Opens in a new window Malignant neoplasm of peripheral nerves of right upper limb, including shoulder – Malignant neoplasm of peripheral nerves of left upper limb, including shoulder
C47.21 – C47.22 – Opens in a new window Malignant neoplasm of peripheral nerves of right lower limb, including hip – Malignant neoplasm of peripheral nerves of left lower limb, including hip
C47.3 – C47.5 – Opens in a new window Malignant neoplasm of peripheral nerves of thorax – Malignant neoplasm of peripheral nerves of pelvis
C47.8 Malignant neoplasm of overlapping sites of peripheral nerves and autonomic nervous system
C48.0 – C48.8 – Opens in a new window Malignant neoplasm of retroperitoneum – Malignant neoplasm of overlapping sites of retroperitoneum and peritoneum
C49.0 Malignant neoplasm of connective and soft tissue of head, face and neck
C49.11 – C49.12 – Opens in a new window Malignant neoplasm of connective and soft tissue of right upper limb, including shoulder – Malignant neoplasm of connective and soft tissue of left upper limb, including shoulder
C49.21 – C49.22 – Opens in a new window Malignant neoplasm of connective and soft tissue of right lower limb, including hip – Malignant neoplasm of connective and soft tissue of left lower limb, including hip
C49.3 – C49.8 – Opens in a new window Malignant neoplasm of connective and soft tissue of thorax – Malignant neoplasm of overlapping sites of connective and soft tissue
C50.011 – C50.012 – Opens in a new window Malignant neoplasm of nipple and areola, right female breast – Malignant neoplasm of nipple and areola, left female breast
C50.021 – C50.022 – Opens in a new window Malignant neoplasm of nipple and areola, right male breast – Malignant neoplasm of nipple and areola, left male breast
C50.111 – C50.112 – Opens in a new window Malignant neoplasm of central portion of right female breast – Malignant neoplasm of central portion of left female breast
C50.121 – C50.122 – Opens in a new window Malignant neoplasm of central portion of right male breast – Malignant neoplasm of central portion of left male breast
C50.211 – C50.212 – Opens in a new window Malignant neoplasm of upper-inner quadrant of right female breast – Malignant neoplasm of upper-inner quadrant of left female breast
C50.221 – C50.222 – Opens in a new window Malignant neoplasm of upper-inner quadrant of right male breast – Malignant neoplasm of upper-inner quadrant of left male breast
C50.311 – C50.312 – Opens in a new window Malignant neoplasm of lower-inner quadrant of right female breast – Malignant neoplasm of lower-inner quadrant of left female breast
C50.321 – C50.322 – Opens in a new window Malignant neoplasm of lower-inner quadrant of right male breast – Malignant neoplasm of lower-inner quadrant of left male breast
C50.411 – C50.412 – Opens in a new window Malignant neoplasm of upper-outer quadrant of right female breast – Malignant neoplasm of upper-outer quadrant of left female breast
C50.421 – C50.422 – Opens in a new window Malignant neoplasm of upper-outer quadrant of right male breast – Malignant neoplasm of upper-outer quadrant of left male breast
C50.511 – C50.512 – Opens in a new window Malignant neoplasm of lower-outer quadrant of right female breast – Malignant neoplasm of lower-outer quadrant of left female breast
C50.521 – C50.522 – Opens in a new window Malignant neoplasm of lower-outer quadrant of right male breast – Malignant neoplasm of lower-outer quadrant of left male breast
C50.611 – C50.612 – Opens in a new window Malignant neoplasm of axillary tail of right female breast – Malignant neoplasm of axillary tail of left female breast
C50.621 – C50.622 – Opens in a new window Malignant neoplasm of axillary tail of right male breast – Malignant neoplasm of axillary tail of left male breast
C50.811 – C50.812 – Opens in a new window Malignant neoplasm of overlapping sites of right female breast – Malignant neoplasm of overlapping sites of left female breast
C50.821 – C50.822 – Opens in a new window Malignant neoplasm of overlapping sites of right male breast – Malignant neoplasm of overlapping sites of left male breast
C51.0 – C51.9 – Opens in a new window Malignant neoplasm of labium majus – Malignant neoplasm of vulva, unspecified
C52 Malignant neoplasm of vagina
C53.0 – C53.8 – Opens in a new window Malignant neoplasm of endocervix – Malignant neoplasm of overlapping sites of cervix uteri
C54.0 – C54.8 – Opens in a new window Malignant neoplasm of isthmus uteri – Malignant neoplasm of overlapping sites of corpus uteri
C56.1 – C56.2 – Opens in a new window Malignant neoplasm of right ovary – Malignant neoplasm of left ovary
C57.01 – C57.02 – Opens in a new window Malignant neoplasm of right fallopian tube – Malignant neoplasm of left fallopian tube
C57.11 – C57.12 – Opens in a new window Malignant neoplasm of right broad ligament – Malignant neoplasm of left broad ligament
C57.21 – C57.22 – Opens in a new window Malignant neoplasm of right round ligament – Malignant neoplasm of left round ligament
C57.3 Malignant neoplasm of parametrium
C57.4 Malignant neoplasm of uterine adnexa, unspecified
C57.7 Malignant neoplasm of other specified female genital organs
C57.8 Malignant neoplasm of overlapping sites of female genital organs
C57.9 Malignant neoplasm of female genital organ, unspecified
C60.0 – C60.8 – Opens in a new window Malignant neoplasm of prepuce – Malignant neoplasm of overlapping sites of penis
C61 Malignant neoplasm of prostate
C63.00 – C63.8 – Opens in a new window Malignant neoplasm of unspecified epididymis – Malignant neoplasm of overlapping sites of male genital organs
C64.1 – C64.2 – Opens in a new window Malignant neoplasm of right kidney, except renal pelvis – Malignant neoplasm of left kidney, except renal pelvis
C65.1 – C65.2 – Opens in a new window Malignant neoplasm of right renal pelvis – Malignant neoplasm of left renal pelvis
C66.1 – C66.2 – Opens in a new window Malignant neoplasm of right ureter – Malignant neoplasm of left ureter
C67.0 – C67.8 – Opens in a new window Malignant neoplasm of trigone of bladder – Malignant neoplasm of overlapping sites of bladder
C68.0 – C68.8 – Opens in a new window Malignant neoplasm of urethra – Malignant neoplasm of overlapping sites of urinary organs
C69.01 – C69.02 – Opens in a new window Malignant neoplasm of right conjunctiva – Malignant neoplasm of left conjunctiva
C69.11 – C69.12 – Opens in a new window Malignant neoplasm of right cornea – Malignant neoplasm of left cornea
C69.21 – C69.22 – Opens in a new window Malignant neoplasm of right retina – Malignant neoplasm of left retina
C69.31 – C69.32 – Opens in a new window Malignant neoplasm of right choroid – Malignant neoplasm of left choroid
C69.41 – C69.42 – Opens in a new window Malignant neoplasm of right ciliary body – Malignant neoplasm of left ciliary body
C69.51 – C69.52 – Opens in a new window Malignant neoplasm of right lacrimal gland and duct – Malignant neoplasm of left lacrimal gland and duct
C69.61 – C69.62 – Opens in a new window Malignant neoplasm of right orbit – Malignant neoplasm of left orbit
C69.81 – C69.82 – Opens in a new window Malignant neoplasm of overlapping sites of right eye and adnexa – Malignant neoplasm of overlapping sites of left eye and adnexa
C70.0 Malignant neoplasm of cerebral meninges
C71.0 – C71.9 – Opens in a new window Malignant neoplasm of cerebrum, except lobes and ventricles – Malignant neoplasm of brain, unspecified
C73 Malignant neoplasm of thyroid gland
C74.01 – C74.02 – Opens in a new window Malignant neoplasm of cortex of right adrenal gland – Malignant neoplasm of cortex of left adrenal gland
C74.11 – C74.12 – Opens in a new window Malignant neoplasm of medulla of right adrenal gland – Malignant neoplasm of medulla of left adrenal gland
C75.0 Malignant neoplasm of parathyroid gland
C75.4 Malignant neoplasm of carotid body
C75.5 Malignant neoplasm of aortic body and other paraganglia
C79.31 Secondary malignant neoplasm of brain
C79.51 Secondary malignant neoplasm of bone
C79.52 Secondary malignant neoplasm of bone marrow
C81.01 – C81.09 – Opens in a new window Nodular lymphocyte predominant Hodgkin lymphoma, lymph nodes of head, face, and neck – Nodular lymphocyte predominant Hodgkin lymphoma, extranodal and solid organ sites
Showing 1 to 100 of 143 entries in Group 1
FirstPrevCurrently Selected12NextLast
Note:
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Providers are reminded to refer to the long descriptors of the CPT codes in their CPT book. The American Medical Association (AMA) and the Centers for Medicare & Medicaid Services (CMS) require the use of short CPT descriptors in policies published on the Web
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141.0–141.6
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Malignant neoplasm of tongue
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141.8–141.9
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Malignant neoplasm of tongue
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142.0–142.2
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Malignant neoplasm of major salivary glands
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142.8–142.9
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Malignant neoplasm of major salivary glands
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143.1
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Lower gum
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143.8
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Other sites of gum
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143.9
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Gum, unspecified
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144.0–144.1
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Malignant neoplasm of floor of mouth
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144.8–144.9
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Malignant neoplasm of floor of mouth
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145.0–145.6
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Malignant neoplasm of other and unspecified parts of mouth
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145.8–145.9
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Malignant neoplasm of other and unspecified parts of mouth
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146.0–146.9
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Malignant neoplasm of oropharynx
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147.0–147.3
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Malignant neoplasm of nasopharynx
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147.8–147.9
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Malignant neoplasm of nasopharynx
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148.0–148.3
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Malignant neoplasm of hypopharynx
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148.8–148.9
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Malignant neoplasm of hypopharynx
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149.0–149.1
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Malignant neoplasm of other and ill-defined sites within the lip, oral cavity and pharynx
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149.8–149.9
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Malignant neoplasm of other and ill-defined sites within the lip, oral cavity and pharynx
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150.0–150.5
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Malignant neoplasm esophagus
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150.8–150.9
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Malignant neoplasm esophagus
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153.0–153.9
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Malignant neoplasm of colon
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154.0–154.3
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Malignant neoplasm of rectum, rectosigmoid junction and anus
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154.8
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Malignant neoplasm of other sites of rectum rectosigmoid junction and anus
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155.0–155.2
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Malignant neoplasm of liver and intrahepatic bile ducts
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156.0–156.2
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Malignant neoplasm of gallbladder and extrahepatic bile ducts
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156.8–156.9
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Malignant neoplasm of gallbladder and extrahepatic bile ducts
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157.0–157.4
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Malignant neoplasm of pancreas
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157.8–157.9
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Malignant neoplasm of pancreas
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158.0
|
Malignant neoplasm of retroperitoneum
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158.8–158.9
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Malignant neoplasm of retroperitoneum and peritoneum
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160.0–160.5
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Malignant neoplasm of nasal cavities, middle ear and accessory sinuses
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160.8–160.9
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Malignant neoplasm of nasal cavities, middle ear and accessory sinuses
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161.0–161.3
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Malignant neoplasm of larynx
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161.8–161.9
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Malignant neoplasm of larynx
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162.0
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Malignant neoplasm of trachea, bronchus and lung
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162.2–162.5
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Malignant neoplasm of trachea, bronchus and lung
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162.8–162.9
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Malignant neoplasm of trachea, bronchus and lung
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163.0–163.1
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Malignant neoplasm of pleura
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163.8–163.9
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Malignant neoplasm of pleura
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164.0–164.3
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Malignant neoplasm of thymus, heart and mediastinum
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164.8–164.9
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Malignant neoplasm of thymus, heart and mediastinum
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171.0
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Malignant neoplasm of connective and other soft tissue of head face and neck
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171.2–171.9
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Malignant neoplasm of connective and other soft tissue
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174.0–174.6*
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Malignant neoplasm of female breast
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174.8–174.9*
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Malignant neoplasm of female breast
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175.0*
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Malignant neoplasm of male breast
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175.9*
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Malignant neoplasm of other and unspecified sites of male breast
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185
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Malignant neoplasm of prostate
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190.0–190.9
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Malignant neoplasm of eye
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191.0–191.9
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Malignant neoplasm of brain
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192.0–192.3
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Malignant neoplasm of other and unspecified parts of nervous system
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192.8–192.9
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Malignant neoplasm of other and unspecified parts of nervous system
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193
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Malignant neoplasm of thyroid gland
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194.0–194.1
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Malignant neoplasm of other endocrine glands and related structures
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195.0–195.5
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Malignant neoplasm of other and ill-defined sites
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195.8
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Malignant neoplasm of other specified sites
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196.0
|
Secondary and unspecified malignant neoplasm of lymph nodes of head face and neck
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198.3
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Secondary malignant neoplasm of brain and spinal cord
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225.1–225.2
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Benign neoplasm of brain and other parts of nervous system
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227.3–227.4
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Benign neoplasm of other endocrine glands and related structures
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227.6
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Benign neoplasm of aortic body and other paraganglia
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747.81
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Congenital anomalies of cerebrovascular system
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Note: * ICD-9-CM codes 174.0, 174.1, 174.2, 174.3, 174.4, 174.5, 174.6, 174.8, 174.9, 175.0 and 175.9 – Indications will include some left breast tumors due to risk to immediately adjacent cardiac and pericardial structures, though IMRT would only rarely if ever be medically necessary for tumors of the right breast.
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179
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Malignant neoplasm of uterus-part unspecified
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180.0–180.1
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Malignant neoplasm of cervix uteri
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180.8–180.9
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Malignant neoplasm of cervix uteri
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182.0–182.1
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Malignant neoplasm of body of uterus
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182.8
|
Malignant neoplasm of other specified sites of body of uterus
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183.0
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Malignant neoplasm of ovary
|
183.2–183.5
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Malignant neoplasm of ovary and other uterine adnexa
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183.8–183.9
|
Malignant neoplasm of ovary and other uterine adnexa
|
184.0
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Malignant neoplasm of vagina
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184.8–184.9
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Malignant neoplasm of other and unspecified female genital organs
|
198.4
|
Sec malig neo nerve nec
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200.00–200.08
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Reticulosarcoma
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200.10–200.18
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Lymphosarcoma
|
200.20–200.28
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Burkitt’s tumor or lymphoma
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200.30–200.38
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Marginal zone lymphoma
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200.40–200.48
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Mantle cell lymphoma
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200.50–200.58
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Primary central nervous system lymphoma
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200.60–200.68
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Anaplastic large cell lymphoma
|
200.70–200.78
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Large cell lymphoma
|
200.80–200.88
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Other named variants of lymphosarcoma and reticulosarcoma
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V49.89
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Other specified conditions influencing health status
|
- The reasonable and necessary requirements as outlined under the “Indications and Limitations of Coverage and/or Medical Necessity” section of this LCD and must be available to Medicare for review upon request.
- The prescription must define the goals and requirements of the treatment plan, including the specific dose constraints for the target(s) and nearby critical structures.
- A statement by the treating physician documenting the special need for performing IMRT on the patient in question, rather than performing conventional or 3-D treatment planning and delivery.
- A signed and dated IMRT inverse plan that meets prescribed dose constraints for the PTV and surrounding normal tissue using either Dynamic Multi-Leaf Collimator (DMLC) or Segmented Multi-Leaf Collimator (SMLC) (average number of “steps” required to meet IMRT delivery is five), or inverse planned IMRT solid compensators to achieve intensity modulation radiation delivery.
- The target verification methodology that includes the following:
- Documentation of the Clinical Treatment Volume (CTV) and the PTV.
- Documentation of immobilization and patient positioning.
- Means of dose verification and secondary means of verification.
- The MUs generated by the IMRT treatment plan must be independently checked before the patient’s first treatment.
- Documentation of fluence distributions recomputed in a phantom is required, or an equivalent methodology consistent with patient-specific IMRT treatment verification described above.
- Documentation that accounts for structures moving in and out of high and low dose regions created by respiration. Voluntary breath-holding is not considered appropriate and the solution for movement can best be accomplished with gating technology.
- Documentation for clinical treatment planning (77261–77263) should evidence the criteria are met, which are outlined in The ASTRO/ACR Guide to Radiation Oncology Coding 2005, page 38.