77422 High energy neutron radiation treatment delivery; single treatment area using a single port or parallel-opposed ports with no blocks or simple blocking (Report required)

77423 1 or more isocenter(s) with coplanar or non-coplanar geometry with blocking and/or wedge, and/or compensator(s) (Report required)


Radiation treatment management is reported in units of five fractions or treatment sessions, regardless of the actual time period in which the services are furnished. The services need not be furnished on consecutive days. Multiple fractions representing two or more treatment sessions furnished on the same day may be counted separately as long as there has been a distinct break in therapy sessions, and the fractions are of the character usually furnished on different days. Code 77427 is also reported if there are three or four fractions beyond a multiple of five at the end of a course of treatment; one or two fractions beyond a multiple of five at the end of a course of treatment are not reported separately. Procedure codes 77427-77469 are for the professional component only, no modifier required.

The professional services furnished during treatment management typically consists of:

• Review of port films;

• Review of dosimetry, dose delivery, and treatment parameters;

• Review of patient treatment set-up;

• Examination of patient for medical evaluation and management (eg, assessment of the patient’s response to treatment, coordination of care and treatment, review of imaging and/or lab results).

77427 Radiation treatment management, five treatments (Weekly clinical management is based on five fractions delivered comprising one week regardless of the time interval separating the delivery of treatments)

77431 Radiation therapy management with complete course of therapy consisting of one or two fractions only

(77431 is not to be used to fill in the last week of a long course of therapy)

77432 Stereotactic radiation treatment management of cranial lesion(s) (complete course of treatment consisting of one session)

77435 Stereotactic body radiation therapy, treatment management, per treatment course, to one or more lesions, including image guidance, entire course not to exceed 5 fractions (Do not report 77435 in conjunction with 77427-77432)

77469 Intraoperative radiation treatment management

77470 Special treatment procedure (eg, total body irradiation, hemibody radiation, per oral or endocavitary irradiation)

(77470 assumes that the procedure is performed 1or more times during the course of therapy, in addition to daily or weekly patient management)

77499 Unlisted procedure, therapeutic radiology treatment management