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Official Description

3-dimensional radiotherapy plan, including dose-volume histograms

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

A 3-dimensional (3-D) radiotherapy plan is a sophisticated approach utilized during the treatment planning phase for radiation therapy aimed at malignant neoplasms. This method involves the creation of a computer-generated 3-D reconstruction of both the tumor and the critical structures that are in proximity to it. The process begins with the acquisition of direct imaging data, typically through computed tomography (CT) scans and/or magnetic resonance imaging (MRI), which are essential for generating accurate 3-D images. These images are crucial as they provide a detailed visualization of the tumor's location and its relationship to surrounding healthy tissues and vital organs.

In conjunction with the 3-D reconstruction, dose-volume histograms (DVH) are employed. DVH is a graphical representation that illustrates the distribution of radiation doses across the 3-D model, allowing healthcare professionals to analyze the frequency distribution of average dose values. This analysis is pivotal in determining the optimal target dose that will effectively eradicate the tumor while minimizing exposure to critical structures and healthy tissue. The integration of the 3-D reconstruction with DVH enables healthcare providers to tailor the radiation treatment plan to the individual patient's unique anatomical features, ensuring a more precise and effective treatment strategy.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The 3-dimensional radiotherapy plan is indicated for the treatment of malignant neoplasms, where precise targeting of the tumor is essential to maximize treatment efficacy while minimizing damage to surrounding healthy tissues. The following conditions may warrant the use of this advanced planning technique:

  • Malignant Neoplasms The primary indication for a 3-D radiotherapy plan is the presence of malignant tumors that require radiation therapy for effective treatment.
  • Complex Tumor Locations Tumors located near critical structures or organs, where careful planning is necessary to avoid collateral damage during radiation treatment.
  • Need for Dose Optimization Situations where precise dose distribution is crucial to ensure adequate tumor control while protecting healthy tissue.

2. Procedure

The procedure for creating a 3-dimensional radiotherapy plan involves several critical steps that ensure the accurate representation of the tumor and surrounding anatomy. Each step is essential for developing an effective treatment strategy.

  • Step 1: Imaging Acquisition The first step involves obtaining high-quality imaging data through CT scans and/or MRI. These imaging modalities provide detailed cross-sectional images of the patient's anatomy, which are essential for accurately visualizing the tumor and its relationship to adjacent structures.
  • Step 2: 3-D Reconstruction Using the imaging data, a computer generates a 3-D reconstruction of the tumor and surrounding tissues. This reconstruction allows for a comprehensive view of the tumor's size, shape, and location, facilitating better planning of the radiation treatment.
  • Step 3: Dose-Volume Histogram Generation Following the 3-D reconstruction, dose-volume histograms (DVH) are created. The DVH provides a graphical representation of the radiation dose distribution across the tumor and surrounding tissues, allowing for analysis of how different dose levels will affect both the tumor and healthy structures.
  • Step 4: Treatment Plan Adjustment Based on the insights gained from the DVH, adjustments to the radiation treatment plan can be made. This step is crucial for optimizing the target dose to effectively eradicate the tumor while sparing critical structures and healthy tissue.

3. Post-Procedure

After the completion of the 3-dimensional radiotherapy planning procedure, the patient may undergo a review of the treatment plan to ensure that it aligns with their specific anatomical considerations and treatment goals. Continuous monitoring and adjustments may be necessary throughout the course of radiation therapy to account for any changes in the patient's condition or tumor response. Additionally, follow-up imaging may be required to assess the effectiveness of the treatment and to make any further modifications to the plan as needed.

Short Descr 3-D RADIOTHERAPY PLAN
Medium Descr 3-D RADIOTHERAPY PLAN DOSE-VOLUME HISTOGRAMS
Long Descr 3-dimensional radiotherapy plan, including dose-volume histograms
Status Code Active Code
Global Days XXX - Global Concept Does Not Apply
PC/TC Indicator (26, TC) 1 - Diagnostic Tests for Radiology Services
Multiple Procedures (51) 0 - No payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50) 0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 0 - Payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62) 0 - Co-surgeons not permitted for this procedure.
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Procedure or Service, Not Discounted when Multiple
ASC Payment Indicator Radiology service paid separately when provided integral to a surgical procedure on ASC list; payment based on MPFS nonfacility PE RVUs.
Type of Service (TOS) 6 - Therapeutic Radiology
Berenson-Eggers TOS (BETOS) P7A - Oncology - radiation therapy
MUE 1
CCS Clinical Classification 211 - Therapeutic radiology

This is a primary code that can be used with these additional add-on codes.

77293 Addon Code MPFS Status: Active Code APC N ASC N1 Respiratory motion management simulation (List separately in addition to code for primary procedure)
26 Professional component: certain procedures are a combination of a physician or other qualified health care professional component and a technical component. when the physician or other qualified health care professional component is reported separately, the service may be identified by adding modifier 26 to the usual procedure number.
TC Technical component; under certain circumstances, a charge may be made for the technical component alone; under those circumstances the technical component charge is identified by adding modifier 'tc' to the usual procedure number; technical component charges are institutional charges and not billed separately by physicians; however, portable x-ray suppliers only bill for technical component and should utilize modifier tc; the charge data from portable x-ray suppliers will then be used to build customary and prevailing profiles
GC This service has been performed in part by a resident under the direction of a teaching physician
59 Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25.
X4 Episodic/focused services: for reporting services by clinicians who provide focused care on particular types of treatment limited to a defined period and circumstance; the patient has a problem, acute or chronic, that will be treated with surgery, radiation, or some other type of generally time-limited intervention; reporting clinician service examples include but are not limited to, the orthopedic surgeon performing a knee replacement and seeing the patient through the postoperative period
CR Catastrophe/disaster related
Q6 Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area
X5 Diagnostic services requested by another clinician: for reporting services by a clinician who furnishes care to the patient only as requested by another clinician or subsequent and related services requested by another clinician; this modifier is reported for patient relationships that may not be adequately captured by the above alternative categories; reporting clinician service examples include but are not limited to, the radiologist's interpretation of an imaging study requested by another clinician
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
Q1 Routine clinical service provided in a clinical research study that is in an approved clinical research study
76 Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service.
GZ Item or service expected to be denied as not reasonable and necessary
AQ Physician providing a service in an unlisted health professional shortage area (hpsa)
GW Service not related to the hospice patient's terminal condition
52 Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use).
53 Discontinued procedure: under certain circumstances, the physician or other qualified health care professional may elect to terminate a surgical or diagnostic procedure. due to extenuating circumstances or those that threaten the well being of the patient, it may be necessary to indicate that a surgical or diagnostic procedure was started but discontinued. this circumstance may be reported by adding modifier 53 to the code reported by the individual for the discontinued procedure. note: this modifier is not used to report the elective cancellation of a procedure prior to the patient's anesthesia induction and/or surgical preparation in the operating suite. for outpatient hospital/ambulatory surgery center (asc) reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use).
79 Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.)
95 Synchronous telemedicine service rendered via a real-time interactive audio and video telecommunications system: synchronous telemedicine service is defined as a real-time interaction between a physician or other qualified health care professional and a patient who is located at a distant site from the physician or other qualified health care professional. the totality of the communication of information exchanged between the physician or other qualified health care professional and the patient during the course of the synchronous telemedicine service must be of an amount and nature that would be sufficient to meet the key components and/or requirements of the same service when rendered via a face-to-face interaction. modifier 95 may only be appended to the services listed in appendix p. appendix p is the list of cpt codes for services that are typically performed face-to-face, but may be rendered via a real-time (synchronous) interactive audio and video telecommunications system.
CC Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed)
GV Attending physician not employed or paid under arrangement by the patient's hospice provider
LT Left side (used to identify procedures performed on the left side of the body)
PD Diagnostic or related non diagnostic item or service provided in a wholly owned or operated entity to a patient who is admitted as an inpatient within 3 days
PN Non-excepted service provided at an off-campus, outpatient, provider-based department of a hospital
Q0 Investigational clinical service provided in a clinical research study that is in an approved clinical research study
Q5 Service furnished under a reciprocal billing arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area
RT Right side (used to identify procedures performed on the right side of the body)
SA Nurse practitioner rendering service in collaboration with a physician
XE Separate encounter, a service that is distinct because it occurred during a separate encounter
XP Separate practitioner, a service that is distinct because it was performed by a different practitioner
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
Date
Action
Notes
2014-01-01 Changed Description Changed
2006-01-01 Changed Code description changed.
1994-01-01 Added First appearance in code book in 1994.
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