Radiation Coding

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Radiation Coding
Valerian Chyle, Jr., M.D. Radiation
Oncologist Texas Oncology, P.A. Texas Cancer
Center Round Rock

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Radiation Coding

• Date Start / End
• Location of Radiation
• Radiation Volume Organ elective area
• Regional Modality
• Regional Dose subclinical dose
• Boost Modality
• Boost Dose
• of Treatments

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Radiation Volume Pages 151-154

• 00 No Radiation
• 01 Eye/Orbit
• 02 Pituitary
• 03 Brain (NOS) Whole Brain
• 04 Brain (Limited)
• 05 Head and Neck (NOS)
• 06 Head and Neck (limited)
• 07 Glottis
• 08 Sinuses

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Radiation Volume Pages 151-154

• 09 Parotid
• 10 Chest/lung (NOS)
• 11 Lung (limited)
• 12 Esophagus
• 13 Stomach
• 14 Liver
• 15 Pancreas
• 16 Kidney
• 17 Abdomen (NOS)

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Radiation Volume Pages 151-154

• 18 Breast
• 19 Breast/lymph nodes
• 20 Chest wall
• 21 Chest wall/lymph nodes
• 22 Mantle, Minimantle
• 23 Lower extended field
• 24 Spine
• 25 Skull
• 26 Ribs

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Radiation Volume Pages 151-154

• 27 Hip
• 28 Pelvic Bones
• 29 Pelvis (NOS)
• 30 Skin
• 31 Soft Tissue
• 32 Hemibody
• 33 Whole body
• 34 Bladder and pelvis
• 35 Prostate and pelvis

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Radiation Volume Pages 151-154

• 36 Uterus and cervix
• 37 Shoulder
• 38 Extremity bone, NOS
• 39 Inverted Y
• 40 Spinal cord
• 41 Prostate
• 50 Thyroid
• 60 Lymph Node region, NOS
• 98 Other
• 99 - Unknown

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Regional Modality Pages 155-157

• 00 No radiation treatment
• 20 External beam, NOS
• 21 Orthovoltage
• 22 Cobalt-60, Cesium-137
• 23 Photons (2-5 MV)
• 24 Photons (6-10 MV)
• 25 Photons (11-19 MV)
• 26 Photons (gt19 MV)
• 27 Photons (mixed energies)

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Regional Modality Pages 155-157

• 28 Electrons
• 29 Pho tons and electrons mixed
• 30 Neutrons, with or without photons/electrons
• 31 IMRT
• 32 Conformal or 3-D therapy
• 40 Protons
• 41 Stereotactic radiosurgery, NOS
• 42 Linac radiosurgery
• 43 Gamma Knife

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Regional Modality Pages 155-157

• 50 Brachytherapy, NOS
• 51 Brachytherapy, Intracavitary, LDR
• 52 Brachytherapy, Intracavitary, HDR
• 53 Brachytherapy, Interstitial, LDR
• 54 Brachytherapy, Interstitial, HDR
• 55 Radium

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Regional Modality Pages 155-157

• 60 Radioisotopes, NOS
• 61 Strontium-89
• 62 Strontium-90
• 80 Combination modality, specified
• 85 Combination modality, NOS
• 98 Other, NOS
• 99 Unknown

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Regional Dose Page 158

• Typically Identified in the Tx summary or Tx
  completion Note
• Prescribed to a point or an isodose line, CAX
  dose is preferred.
• cGy Rad
• XXXX - Record Actual Regional Dose Delivered
• 00000 No radiation delivered
• 88888 N/A, Brachytherapy or radioisotopes
  administered to patient.
• 99999 Regional XRT was delivered but the dose
  is unknown or it is unknown whether XRT was
  administered.

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Boost Modality Pages 159-161

• Same Rules as Regional Modality
• More likely to be high tech modalities
• IMRT
• Gamma knife
• Stereotactic Radiosurgery
• LDR or HDR Brachytherapy

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Boost Dose Page 162

• Difference between the prescribed maximum dose
  and the regional dose.
• 00000 No boost delivered
• 88888 - If boost is with brachytherapy
• 99999 Boost was delivered but the dose is
  unknown

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Number of treatments Page 163

• 00 No XRT was delivered
• 01-99 The actual of treatments delivered. If
  brachytherapy was used, count all brachytherapy
  as 1, regardless of how many fractions were used.
• 99 Number of treatments is unknown or it is not
  known whether or not XRT was delivered

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