New Gating Code Released
The American Medical Association recently released early information on code 0197T, a CPT® category III code, to describe 4-dimensional tracking.
The descriptor of 0197T is intrafraction localization tracking of target or patient motion during delivery of radiation therapy. This would cover 4-dimensional positional tracking using gating for each fraction of treatment. This code is scheduled to be technical only and reported with the treatment delivery code. Any type of linear accelerator that provides tumor or patient motion tracking should qualify for reimbursement for 0197T.
Because category III codes are paid exclusively by local carrier determination, reimbursement for this code currently remains variable different parts of the country. In Florida, this code is currently paid at the participating fee schedule of $120.76. In most other areas of the country, this a tracking code to capture usage only. This code will be included in the CPT® manual in 2010.
You can view a list of partial proposed 2009 and 2010 category III codes at http://www.ama-assn.org/ama1/pub/upload/mm/362/categoryiiimedium.pdf
Paul J. Schilling, MD, FACRO
Community Cancer Center of North Florida