Billing and Coding: Superficial Radiation Therapy (SRT) for the Treatment of Nonmelanoma Skin Cancers (NMSC)

This billing/coding guidance states that SRT for nonmelanoma skin cancer is payable only in non-facility settings and requires documentation that the patient is a nonsurgical candidate with a documented discussion preferring SRT. Comprehensive medical record requirements include treatment plan/prescription with dose constraints, physician justification for SRT planning/delivery, DVH review and signatures, dosimetric and target verification (including CTV/PTV), and support for billed ICD-10 and CPT/HCPCS codes; non-covered services must be billed with appropriate modifiers (GY/GZ).

"SRT is covered for the treatment of diagnosed nonmelanoma skin cancer (NMSC) when medical necessity is supported according to the applicable LCD (DL40189)."

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