These guidelines provide general coding and reimbursement information for the CyberKnife® Robotic Radiosurgery System. This information is for your reference only and does not represent a guarantee of coverage or payment. It is important to research coverage and payment for each patient as policies and guidelines may vary by payer and plan.
CODING GUIDELINES
HCPCS codes
Healthcare Common Procedure Coding System (HCPCS) codes are alphanumeric codes used to report the use of drugs, medical devices, supplies and some services. For 2008, the HCPCS codes used to report the procedures associated with the CyberKnife System are:
| HCPCS Code |
Code Description |
APC |
| G0339 |
Image guided, robotic linear accelerator based stereotactic radiosurgery, complete course of therapy in one session, or first session of fractional treatment |
0067 |
| G0340 |
Image guided, robotic linear accelerator based stereotactic radiosurgery, delivery including collimator changes and custom plugging, fractionated treatment, all lesions, per session, 2nd - 5th sessions, max 5 |
0066 |
CPT codes
Current Procedural Terminology (CPT) is a list of descriptive terms and codes for reporting services and procedures performed by physicians and other healthcare professionals. For 2008, the following are CPT codes available for reporting procedures associated with the CyberKnife System:
| CPT Code |
Code Description |
| 61793 |
Stereotactic radiosurgery |
| 77263 |
Therapeutic radiology treatment planning, complex |
| 77280-26 |
Simulation, simple |
| 77290-26 |
Simulation, complex |
| 77295-26 |
Simulation, 3-D complex |
| 77300-26 |
Basic dosimetry calculation |
| 77334-26 |
Treatment devices, design, construction, complex |
| 77370 |
Medical physics consult |
| 77432 |
Stereotactic radiation treatment management of cerebral lesion(s) |
| 77435 |
Stereotactic body radiation treatment management |
Warning:
Reimbursement policies vary widely from insurer to insurer and reimbursement policies of the same insurance may vary in different sections of the country. As reimbursement policies are subject to change, Accuray will endeavor, on a periodic basis, to review and revise, as necessary, all pertinent reimbursement information. Therefore, the information contained herein (while accurate at the time of print) may not be accurate at the time of use. Prior to submission of a claim for reimbursement, the user should contact the insurer (i.e. Medicare, Medicaid or private payer) to verify applicable codes and reimbursement levels. This is assuming all parts are FDA approved.
PLEASE NOTE:
All five-digit numeric CPT codes, descriptions, instructions and guidelines are Copyright 2007 of the American Medical Association. To purchase AMA's products please contact the American Medical Association at 800-634-6922. Accuray assumes no responsibility for the consequences related to the use of information contained in this publication. All codes presented in this guide are for informational purposes only. Presented is a menu of codes intended for treatment prescription guidelines. Accuray realizes there are variations between physicians and hospitals concerning the performance of procedures, depending upon physician technique and/or education/training. All codes and descriptions are excerpted from the AMA CPT-4 Codebook. AMA case studies and the ASTRO/ACR Guide to Radiation Oncology Coding 2007. DRG guidelines will determine inpatient reimbursement for Medicare recipients. Only the specific services performed by the healthcare provider should be billed. Procedures should be ordered and then performed, documented and coded. Operative or other procedure reports should be detailed, dictated, signed, and placed in the medical chart.