77299
HCPCS/CPT
Prior Authorization
No Prior Auth Required
No active coverage policies found for this code (low confidence)
Medicare Pricing
Work RVU
0.00
Facility
N/A
Non-Facility
N/A
Key Coverage Criteria
- TTF therapy is consideredmedically necessarywhen criteria A, B and C areallmet:
- An FDA approved device is used;and
- Tumor being treated is a histologically-confirmed supratentorial glioblastoma (known also as glioblastoma multiforme [GBM] or World Health Organization [WHO] grade IV astrocytoma);and
- Either criteria 1or2 are met:Newly diagnosed GBM whenallthe following criteria are met:Initial treatment with debulking surgery or biopsy followed by chemoradiation with concomitant temozolomide and radiotherapy has been completed with no documented tumor progression*;andTTF is used in combination with temozolomide;andIndividual has Karnofsky Performance Status (KPS) score of 70 or higherorEastern Cooperative Oncology Group (ECOG) performance status 0-1;andIndividual or caregiver has been traine [...]
- Newly diagnosed GBM whenallthe following criteria are met:Initial treatment with debulking surgery or biopsy followed by chemoradiation with concomitant temozolomide and radiotherapy has been completed with no documented tumor progression*;andTTF is used in combination with temozolomide;andIndividual has Karnofsky Performance Status (KPS) score of 70 or higherorEastern Cooperative Oncology Group (ECOG) performance status 0-1;andIndividual or caregiver has been trained and is willing and able to [...]
- Initial treatment with debulking surgery or biopsy followed by chemoradiation with concomitant temozolomide and radiotherapy has been completed with no documented tumor progression*;and
3 Active Policies
ANTHEM-CG-DME-44 — CG-DME-44 Electric Tumor Treatment Field (TTF)
ANTHEM-RAD.00012 — THER-RAD.00012 Electrophysiology-Guided Noninvasive Stereotactic Cardiac Radioablation
REGENCE-DME85 — Tumor Treatment Field Therapy (TTFT)
Related Codes
Have a follow-up question?
Ask Verity about documentation requirements, denial risks, or coverage in your state.