2018 New Radiation Coding Rules - CRGC



2018 New Radiation Coding RulesRadiation Coding ScenariosPlease use the codes in the slides to complete the radiation coding scenarios below. The Phase I codes may be used to assign the Phase II and Phase 3 data items. Coding scenarios should be completed prior to the webinar. The radiation summaries in cases 2-6 are from directly from radiation charts. We will review the cases during the webinar.Case 1-OropharynxTreatment Dates: 1/22/18-2/10/18Site: Head & NeckDose: 70 Gy in 35 fractions over 50 elapsed days.Techniques: IMRT in the 6 MV linear accelerator with Aquaplast immobilization and custom blocking with daily KV image guidance. FieldsCodeRationaleReason no RadiationRadiation Start DateRadiation End DatePhase I Radiation Primary Treatment VolumePhase I Radiation to Draining Lymph NodesPhase I Treatment ModalityPhase I EBRT Planning TechniquePhase I Dose per FractionPhase I Number of FractionsPhase I Total DosePhase II Radiation Primary Treatment VolumePhase II Radiation to Draining Lymph NodesPhase II Treatment ModalityPhase II EBRT Planning TechniquePhase II Dose per FractionPhase II Number of FractionsPhase II Total DosePhase III Radiation Primary Treatment VolumePhase III Radiation to Draining Lymph NodesPhase III Treatment ModalityPhase III EBRT Planning TechniquePhase III Dose per FractionPhase III Number of FractionsPhase III Total DoseNumber of Phases of Radiation Treatment to this VolumeRadiation Discontinued EarlyTotal DoseCase 2- ProstateSummary of I-125 seed implant: On 1/21/18, 66 iodine-125 seeds were implanted into the prostate gland/seminal vesicles with an activity of 0.245 mci/seed. He then received daily external beam therapy using intensity modulation and daily image guiding as outlined below: Treatment SiteEnergyDose/Fx (Gy)# FxDose Correction (Gy)Total Dose (Gy)Start DateEnd DateElapsed Days1-PROSV IMRT6X1.530/300452/11/183/23/18412-SV BST6X1.55/507.53/24/183/31/187Total52.52/11/183/31/1849 FieldsCodeRationaleReason no RadiationRadiation Start DateRadiation End DatePhase I Radiation Primary Treatment VolumePhase I Radiation to Draining Lymph NodesPhase I Treatment ModalityPhase I EBRT Planning TechniquePhase I Dose per FractionPhase I Number of FractionsPhase I Total DosePhase II Radiation Primary Treatment VolumePhase II Radiation to Draining Lymph NodesPhase II Treatment ModalityPhase II EBRT Planning TechniquePhase II Dose per FractionPhase II Number of FractionsPhase II Total DosePhase III Radiation Primary Treatment VolumePhase III Radiation to Draining Lymph NodesPhase III Treatment ModalityPhase III EBRT Planning TechniquePhase III Dose per FractionPhase III Number of FractionsPhase III Total DoseNumber of Phases of Radiation Treatment to this VolumeRadiation Discontinued EarlyTotal DoseCase 3- Lung, Palliative for Stage IIIA T2aN2M0Treatment SiteEnergyDose/Fx (Gy)# FxDose Correction (Gy)Total Dose (Gy)Start DateEnd DateElapsed Days1-Mediastinum6X45/50202/11/182/17/186Total202/11/182/17/186 FieldsCodeRationaleReason no RadiationRadiation Start DateRadiation End DatePhase I Radiation Primary Treatment VolumePhase I Radiation to Draining Lymph NodesPhase I Treatment ModalityPhase I EBRT Planning TechniquePhase I Dose per FractionPhase I Number of FractionsPhase I Total DosePhase II Radiation Primary Treatment VolumePhase II Radiation to Draining Lymph NodesPhase II Treatment ModalityPhase II EBRT Planning TechniquePhase II Dose per FractionPhase II Number of FractionsPhase II Total DosePhase III Radiation Primary Treatment VolumePhase III Radiation to Draining Lymph NodesPhase III Treatment ModalityPhase III EBRT Planning TechniquePhase III Dose per FractionPhase III Number of FractionsPhase III Total DoseNumber of Phases of Radiation Treatment to this VolumeRadiation Discontinued EarlyTotal DoseCase 4- Lung Stage IV T3N2M1bTreatment SiteEnergyDose/Fx (Gy)# FxTotal Dose (Gy)Start DateEnd DateElapsed Days2 L4-SI10X/6X310/10301/7/181/20/18131 Lt Hip15X/6X310/10301/7/181/20/18133 Rt Lung6X1.835/35631/25/184/1/1867Total1/7/184/1/1885 FieldsCodeRationaleReason no RadiationRadiation Start DateRadiation End DatePhase I Radiation Primary Treatment VolumePhase I Radiation to Draining Lymph NodesPhase I Treatment ModalityPhase I EBRT Planning TechniquePhase I Dose per FractionPhase I Number of FractionsPhase I Total DosePhase II Radiation Primary Treatment VolumePhase II Radiation to Draining Lymph NodesPhase II Treatment ModalityPhase II EBRT Planning TechniquePhase II Dose per FractionPhase II Number of FractionsPhase II Total DosePhase III Radiation Primary Treatment VolumePhase III Radiation to Draining Lymph NodesPhase III Treatment ModalityPhase III EBRT Planning TechniquePhase III Dose per FractionPhase III Number of FractionsPhase III Total DoseNumber of Phases of Radiation Treatment to this VolumeRadiation Discontinued EarlyTotal DoseCase 5- CervixTreatment SiteEnergyDose/Fx (Gy)# FxTotal Dose (Gy)Start DateEnd DateElapsed Days1-Pelvis10X/6X1.828/2850.42/1/183/9/1837Vag HDRI-1926.03/318.03/15/183/22/188 FieldsCodeRationaleReason no RadiationRadiation Start DateRadiation End DatePhase I Radiation Primary Treatment VolumePhase I Radiation to Draining Lymph NodesPhase I Treatment ModalityPhase I EBRT Planning TechniquePhase I Dose per FractionPhase I Number of FractionsPhase I Total DosePhase II Radiation Primary Treatment VolumePhase II Radiation to Draining Lymph NodesPhase II Treatment ModalityPhase II EBRT Planning TechniquePhase II Dose per FractionPhase II Number of FractionsPhase II Total DosePhase III Radiation Primary Treatment VolumePhase III Radiation to Draining Lymph NodesPhase III Treatment ModalityPhase III EBRT Planning TechniquePhase III Dose per FractionPhase III Number of FractionsPhase III Total DoseNumber of Phases of Radiation Treatment to this VolumeRadiation Discontinued EarlyTotal DoseCase 6-BreastTreatment SiteEnergyDose/Fx (Gy)#FxTotal Dose (Gy)Start DateEnd DateElapsed Days2R SCF6X/10X1.828/2850.46/22/188/3/18421 R WB6X1.828/2850.46/22/188/3/18423 R B Scar Bst6E25/5108/4/188/10/1864 R Axilla Bst12E25/5108/4/188/10/186Total6/22/188/10/1849 FieldsCodeRationaleReason no RadiationRadiation Start DateRadiation End DatePhase I Radiation Primary Treatment VolumePhase I Radiation to Draining Lymph NodesPhase I Treatment ModalityPhase I EBRT Planning TechniquePhase I Dose per FractionPhase I Number of FractionsPhase I Total DosePhase II Radiation Primary Treatment VolumePhase II Radiation to Draining Lymph NodesPhase II Treatment ModalityPhase II EBRT Planning TechniquePhase II Dose per FractionPhase II Number of FractionsPhase II Total DosePhase III Radiation Primary Treatment VolumePhase III Radiation to Draining Lymph NodesPhase III Treatment ModalityPhase III EBRT Planning TechniquePhase III Dose per FractionPhase III Number of FractionsPhase III Total DoseNumber of Phases of Radiation Treatment to this VolumeRadiation Discontinued EarlyTotal Dose ................
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