eviCore Radiation Oncology Coding Manual

eviCore covers special radiation/physics CPT codes (e.g., 77470, 77370, 77300, 77331, +77293) only for unusual, patient‑specific circumstances and excludes routine uses and many separately billed imaging/physics services that are bundled into planning/delivery codes (e.g., 77301, 77401) or included with SRS/SBRT/IMRT. Key requirements: detailed patient‑specific documentation is mandatory (physician orders and a custom physicist report for 77370; written justification for 77470; physician‑prescribed calculations plus a second distinct algorithmic check for 77300; physician review/signature within 24 hours for 77331), with exceptions considered only on a case‑by‑case basis.

"77470: The radiation oncologist bills CPT® code 77470 when the complexity of the radiation therapy treatment plan is such that significant additional time and effort are required to deliver treatme..."