eviCore Radiation Oncology Coding Manual

The manual lists allowable CPT/HCPCS codes and frequency rules for radiation oncology planning, simulation, dosimetry, devices, image guidance and treatment delivery (including IMRT, SRS/SBRT, protons, brachytherapy, radiopharmaceuticals, SIRT, IORT) and excludes review of SpaceOAR™, Optune®, MRgFUS, GliaSite®, HIPEC and inpatient radiation requests, with numerous situational prohibitions (e.g., 77261–77263 not with superficial/orthovoltage or electronic brachytherapy; +77293 limited to once per episode for respiration‑affected sites only). Reporting requires specific clinical documentation, physician and physicist sign‑off and physician orders/custom reports for special physics or procedures, strict unit/frequency limits (e.g., one unit per episode for most planning codes, imaging limited to one procedure per date, 77417/77336 every five fractions), and inclusion of a code in the manual does not imply it is managed or preauthorized (medical necessity is governed by separate guidelines).