New Code Bundling Rules for Radiation Oncology

On October 1, 2021, Blue Cross and Blue Shield of North Carolina posted a 60-day medical policy notice regarding Superficial Radiation Therapy (SRT).  We are providing additional information that outlines the code bundling rules to ensure providers are filing the appropriate codes. Services performed with SRT, CPT 77401 will be limited as follows:

• Simulation (CPT^® 77280, 77285 or 77290) will only be reimbursable once per 60-day course of SRT
• Basic radiation dosimetry calculation (CPT^® 77300) will only be reimbursable once per 60-day course of SRT
• Image guidance (HCPCS G6001) will not be reimbursable when performed with SRT

More information about the SRT policy notice can be found on the Policies and Guidelines Updates page.

These reimbursement requirements apply to all commercial fully insured, State Health Plan, Administrative Services Only (ASO), and Blue Card Inter-Plan Program Host members.