Billing and Coding: Radiation Therapies

Coverage for radiation therapies requires that the patient's medical record demonstrate medical necessity in accordance with LCD L39553. SRS/SBRT may be covered for oligometastatic disease, palliation, or recurrent disease when beneficiary-specific justification and performance status are documented; non-cancer uses require clear documentation of prior failed therapies. Extensive documentation is required for all radiation treatments, including legible records, signatures, treatment plans with dose constraints, physician justification for specialized techniques, and physics verification steps.

"Radiation therapy is covered when the patient's medical record documents medical necessity consistent with LCD L39553."

Sign up to see full coverage criteria, indications, and limitations.