Stereotactic radiation trmt
CPT 77432 covers the specialized planning and calculation work required for stereotactic radiation therapy, where highly focused radiation beams target tumors with extreme precision, typically requiring complex computer modeling and dose calculations.
This calculator gives a typical-case estimate using standard Medicare modifier rules. Actual payment depends on payer policies, documentation, code-specific CMS status indicators, and locality. Verify before billing.
RVU breakdown
Conversion factor: 32.3465 · Source: CMS MPFS RVU25A · Confidence: High
NCCI bundling edits
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Billing tips
Bill 77432 only once per treatment course, not per fraction delivered. This code covers the planning phase, not the daily delivery.
Impact: Prevents automatic denials and recoupment; overcoding this can trigger audits resulting in $400+ refunds per incorrect claim
Ensure medical physicist's treatment planning documentation is signed and dated by the supervising radiation oncologist before claim submission.
Impact: Missing physician attestation is the leading cause of denials; can delay payment by 30-60 days during appeal process
Document the number of treatment areas/lesions in the planning note; multiple separate targets may justify modifier 59 for additional planning codes.
Impact: Proper documentation can support payment for multiple planning services when treating 3+ distinct lesions, potentially adding $400+ per additional site
Submit claims within 30 days of service completion; stereotactic planning often occurs weeks before treatment delivery, requiring careful date tracking.
Impact: Late filing can result in automatic denials with difficult appeals; timely filing captures full $416.62 reimbursement without delays
Link to specific diagnosis codes indicating the tumor location and type; generic 'neoplasm' codes increase denial risk for this specialized service.
Impact: Specific ICD-10 codes (C79.31 for brain metastasis, C34.11 for upper lobe lung cancer) reduce medical necessity denials by approximately 40%
Do not bill 77432 with simple or 3D conformal planning codes (77261-77263) for the same treatment course; these are mutually exclusive.
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