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CPT®
77418

CPT® Code 77418
Deleted

Official Description

Intensity modulated treatment delivery, single or multiple fields/arcs, via narrow spatially and temporally modulated beams, binary, dynamic MLC, per treatment session

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

Intensity Modulated Radiation Therapy (IMRT) is a sophisticated form of radiation treatment that utilizes advanced technology to deliver precise doses of radiation to a tumor while minimizing exposure to surrounding healthy tissues. This technique involves the use of multiple fields or arcs, which are narrow beams of radiation that can be spatially and temporally modulated. The modulation allows for the adjustment of the intensity of the radiation beams, ensuring that the tumor receives a higher dose necessary for effective treatment, while the adjacent healthy tissues are spared from excessive radiation exposure. The use of dynamic multi-leaf collimators (MLC) further enhances the precision of the treatment by shaping the radiation beams to conform to the three-dimensional shape of the tumor. This targeted approach is crucial in improving treatment outcomes and reducing side effects associated with radiation therapy.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

Intensity Modulated Radiation Therapy (IMRT) is indicated for various clinical scenarios where precise targeting of radiation is essential to maximize tumor control while minimizing damage to surrounding healthy tissues. The following conditions may warrant the use of IMRT:

  • Malignant Tumors IMRT is commonly used to treat various types of cancers, including but not limited to prostate, breast, head and neck, and lung cancers, where the tumor's location and proximity to critical structures necessitate a highly targeted approach.
  • Recurrent Tumors In cases where tumors have recurred after previous treatments, IMRT can provide a focused treatment option to target the recurrent mass effectively.
  • Complex Tumor Shapes Tumors that have irregular shapes or are located near sensitive organs or tissues benefit from IMRT's ability to conform the radiation dose to the tumor's contours.

2. Procedure

The procedure for delivering Intensity Modulated Radiation Therapy (IMRT) involves several critical steps to ensure accurate and effective treatment. Each step is designed to optimize the delivery of radiation to the tumor while protecting healthy tissues.

  • Step 1: Treatment Planning The process begins with a comprehensive treatment planning session, where imaging studies such as CT or MRI scans are performed to accurately locate the tumor and assess its size and shape. This information is crucial for creating a detailed treatment plan that specifies the radiation dose and the configuration of the radiation beams.
  • Step 2: Simulation During the simulation phase, the patient is positioned on the treatment table in a manner that replicates the position they will be in during actual treatment sessions. This may involve the use of immobilization devices to ensure consistent positioning. The radiation oncologist will mark the treatment area on the patient's skin to guide the delivery of radiation.
  • Step 3: Delivery of Radiation The actual delivery of IMRT involves the use of a linear accelerator, which generates the radiation beams. The machine is programmed to deliver the radiation in a series of narrow beams that can be adjusted in intensity. The dynamic MLCs shape the beams to conform to the tumor's contours, allowing for precise targeting. The treatment is delivered in multiple sessions, with each session focusing on specific fields or arcs as determined by the treatment plan.

3. Post-Procedure

After the completion of each IMRT session, patients are typically monitored for any immediate side effects, although many experience minimal discomfort. It is common for patients to receive instructions regarding post-treatment care, which may include recommendations for skin care in the treated area and managing any potential side effects such as fatigue or skin irritation. Follow-up appointments are scheduled to assess the patient's response to treatment and to monitor for any late effects of radiation therapy. The overall recovery process may vary depending on the individual patient's condition and the extent of the treatment.
Short Descr RADIATION TX DELIVERY IMRT
Medium Descr NTSTY MODUL DLVR 1/MLT FLDS/ARCS PR TX SESSION
Long Descr Intensity modulated treatment delivery, single or multiple fields/arcs, via narrow spatially and temporally modulated beams, binary, dynamic MLC, per treatment session
Status Code Active Code
Global Days XXX - Global Concept Does Not Apply
PC/TC Indicator (26, TC) 3 - Technical Component Only Code
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 9 - 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
Type of Service (TOS) 6 - Therapeutic Radiology
Berenson-Eggers TOS (BETOS) P7A - Oncology - radiation therapy
MUE Not applicable/unspecified.
CCS Clinical Classification 211 - Therapeutic radiology
Date
Action
Notes
2015-01-01 Deleted Code deleted
2011-01-01 Changed Short description changed.
2005-01-01 Changed Code description changed.
2002-01-01 Added First appearance in code book in 2002.
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Description
Code
Description
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