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The brachytherapy isodose plan, represented by CPT® Code 77317, is a specialized procedure that involves the creation of a patient-specific radiation treatment plan. This plan is developed by a medical dosimetrist and/or a qualified medical physicist, all under the supervision of a radiation oncologist. Brachytherapy is a form of internal radiation therapy that delivers localized and precise doses of radiation directly to tumors or other medical conditions by implanting radioactive seeds or pellets into body cavities or interstitial tissues. The isodose plan is critical as it determines the technique to be used, the exact dosage of radiation, and the type of radioactive material—such as iodine, palladium, cesium, or iridium—that will be applied. Additionally, the plan assesses the radiation tolerance of surrounding healthy tissues to minimize damage during treatment. In the context of brachytherapy, there are two primary techniques: temporary and permanent. Temporary brachytherapy involves placing a radioactive source inside a catheter or tube for a specified duration, after which the source is removed. This technique can utilize various dosing rates, including low-dose rate (LDR), pulse-dose rate (PDR), and high-dose rate (HDR). In contrast, permanent brachytherapy involves the implantation of seeds or pellets that gradually release their radioactive material over several months until it is completely depleted. The isodose plan for intermediate brachytherapy, as indicated by Code 77317, specifically involves calculations derived from 5 to 10 sources or remote afterloading of 2 to 12 channels, ensuring a comprehensive approach to radiation delivery tailored to the patient's needs.
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The brachytherapy isodose plan (CPT® Code 77317) is indicated for patients requiring localized radiation treatment for various medical conditions, particularly tumors. The specific indications include:
The procedure for creating a brachytherapy isodose plan involves several critical steps, which are detailed as follows:
After the brachytherapy isodose plan has been implemented, post-procedure care is essential for patient safety and recovery. Patients may require monitoring for any immediate side effects related to the radiation treatment. Follow-up appointments are scheduled to assess the effectiveness of the treatment and to manage any potential complications. Additionally, patients may receive instructions regarding activity restrictions, care of the implantation site, and signs of adverse reactions to watch for. The overall recovery process will vary depending on whether temporary or permanent brachytherapy was performed, with specific guidelines provided by the healthcare team to ensure optimal healing and treatment outcomes.
| Short Descr | BRACHYTX ISODOSE INTERMED | Medium Descr | BRACHYTX ISODOSE PLN INTERMED W/DOSIMETRY CAL | Long Descr | Brachytherapy isodose plan; intermediate (calculation[s] made from 5 to 10 sources, or remote afterloading brachytherapy, 2-12 channels), includes basic dosimetry calculation(s) | 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 OPPS relative payment weight. | Type of Service (TOS) | 6 - Therapeutic Radiology | Berenson-Eggers TOS (BETOS) | P7A - Oncology - radiation therapy | MUE | 1 |
| 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. | 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. | 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. | GC | This service has been performed in part by a resident under the direction of a teaching physician | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | 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 | 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 | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| 2015-01-01 | Added | Added |
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