Radiation Therapy Clinical Appeal Documentation Requirements

Covers CPT‑coded radiation therapy planning, physics, dosimetry, simulation, delivery and management services when used for radiation therapy, but 77014 (CT acquisition) is included in simulation codes 77280–77290 and 77295 and should not be billed separately, and 77300 is not separately reportable with specified procedure codes (e.g., 0394T/0395T, 77306–77318, 77321, 77767–77772, 77778). Each service requires date‑specific clinical documentation demonstrating medical necessity (signed physician treatment plan/notes, simulation sheets, physics plans/DVHs, diode orders/readings, treatment records/OTVs), with explicit justification required when allowed units are exceeded or for special procedures such as IMRT, diode dosimetry, 77470, and unlisted physics services.

"CT for Treatment Planning (use of CT acquisition for radiation therapy treatment planning)"

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