eviCore Radiation Oncology Coding Guidelines

eviCore covers specialized radiation oncology CPTs (e.g., 77470, 77370, 77300, 77331, +77293, 77301/SRS/SBRT codes) only for specifically defined, non‑routine, high‑complexity clinical situations and excludes routine, bundled or duplicative services (many IMRT/simulation/routine dosimetry tasks and specified scenarios are not separately reimbursed). Key requirements: patient‑specific physician orders and detailed, custom physicist reports (checklists/templates insufficient), second algorithmic calculations where required, physician review/signature of certain dosimetry within 24 hours, limits of once per episode for 77470/77370, and adherence to CMS CCI/MUE edits.

"77300 medically necessary indications: "Off axis factor""

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