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CPT-Code for Treatment Planning with Tumor Treating Field

Luz Posted Wed 05th of February, 2020 13:26:16 PM
Is there a specific CPT-code for the following procedure “Treatment Planning with Tumor Treating Field” _ Optune Therapy? We are currently billing CPT-code - 95999 (Unlisted neurological or neuromuscular diagnostic procedure). However, I would like to know if there is a better code that we can use. Your help is appreciated.
SuperCoder Answered Thu 06th of February, 2020 04:02:26 AM

Hello Luz,

Thank you for your question.

 

Optune is a portable device. It produces electric fields, called tumor treatment fields (“TT Fields”). Transducer arrays connected to the device deliver TT Fields to the patient’s head. The TT Fields are intended to destroy brain cancer cells.

 

CMS, Local Coverage Determination suggests below code(s) for Tumor Treatment Field Therapy.

  • E0766 Electrical stimulation device used for cancer treatment, includes all accessories, any type
  • A4555 Electrode/transducer for use with electrical stimulation device used for cancer treatment, replacement only

 

There is no specific CPT® code for Treatment Planning with Tumor Treating Field” with Optune Therapy.

 

Note: Do check with your respective payer for coverage guidelines for Optune Therapy; if any.

 

Below is the CMS , LCD policy for Tumor Treatment Field Therapy, for your reference.

https://www.cms.gov/medicare-coverage-database/details/lcd-details.aspx?LCDId=34823&ver=23&SearchType=Advanced&CoverageSelection=Local&ArticleType=BC|SAD|RTC|Reg&PolicyType=Both&s=All&KeyWord=optune&KeyWordLookUp=Doc&KeyWordSearchType=Exact&kq=true&bc=EAAAABAAAAAA&

 

Hope that helps!

Thanks

Luz Posted Fri 07th of February, 2020 14:22:57 PM
Thank you so much!
SuperCoder Answered Mon 10th of February, 2020 00:00:05 AM

Thank you, happy to help.

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