Oncology


Oncology Revenue Cycle Management Services

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ICD-10 Oncology Superbill Example

Appointment Date & Time: Last Seen Date:
Patient: Gender: DOB: MR# Pat Due: INS Due:
Address: Reason:
Home Phone: Cell Phone: E-Mail:
Case Name: Case No: Case Type: Case Date:
Pr Insurance: Member ID: Co-Pay Amount: Deductible:
Rendering Provider: PCP: Referring Provider:
CPT Codes
CPT CodeDescriptionCPT CodeDescriptionCPT CodeDescription
61796Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); 1 simple cranial lesion77331Special dosimetry (e.g., TLD, microdosimetry) (specify), only when prescribed by the treating physician77414Radiation treatment delivery; three or more separate treatment areas; custom blocking, tangential ports wedges, rotational beam, compensators, electron beam; 11-19 MV Complex
61797Each additional cranial lesion, simple (List separately in addition to code for primary procedure)77332Treatment devices, design and construction; simple (simple block, simple bolus)77416Radiation treatment delivery; three or more separate treatment areas; custom blocking, tangential ports wedges, rotational beam, compensators, electron beam; 20 MV or greater
617981 complex cranial lesion77333Intermediate (multiple blocks, stents, bite blocks, special bolus)77417Therapeutic radiology port film(s)
61799Each additional cranial lesion, complex (List separately in addition to code for primary procedure)77334Complex (irregular blocks, special shields, compensators, wedges, molds or casts)77418Intensity modulated treatment delivery, single or multiple fields/arcs, via narrow spatially and temporally modulated beams, binary, dynamic MLC, per treatment session
77261Therapeutic radiology treatment planning; simple77336Continuing medical physics consultation, including assessment of treatment parameters, quality assurance of dose delivery, and review of patient treatment documentation in support of the radiation oncologist, reported per week of therapy77421Stereoscopic X-ray guidance for localization of target volume for the delivery of radiation therapy
77262Therapeutic Radiology treatment planning; intermediate77370Special medical radiation physics consultation77422High energy neutron radiation treatment delivery; single treatment area using a single port or parallel-opposed ports with no blocks or simple blocking
77263Therapeutic Radiology treatment planning; complex77371Radiation treatment delivery, stereotactic radiosurgery (SRS), complete course of treatment of cranial lesion(s) consisting of 1 session; multi-source Cobalt 60 based774231 or more isocenter(s) with coplanar or non-coplanar geometry with blocking and/or wedge, and/or compensator(s)
77280Therapeutic radiology simulation-aided field setting; simple77372Linear accelerator based77427Radiation treatment management, 5 treatments
77285Intermediate77373Stereotactic body radiation therapy, treatment delivery, per fraction to 1 or more lesions, including image guidance, entire course not to exceed 5 fractions77431Radiation therapy management with complete course of therapy consisting of 1 or 2 fractions only
77290Therapeutic Radiology Simulation; complex77399Unlisted procedure, medical radiation physics, dosimetry and treatment devices, and special services77432Stereotactic radiation treatment management of cranial lesion(s) (complete course of treatment consisting of 1 session)
77295Therapeutic Radiology Simulation 3-Dimensional77401Radiation treatment delivery, superficial and/or ortho voltage77435Stereotactic body radiation therapy, treatment management, per treatment course, to 1 or more lesions, including image guidance, entire course not to exceed 5 fractions
77299Unlisted procedure, therapeutic radiology clinical treatment planning77402Radiation treatment delivery, single treatment area, single port or parallel opposed ports, simple blocks or no blocks; up to 577470Special treatment procedure (e.g., total body irradiation, hemibody radiation, per oral, endocavitary or intraoperative cone irradiation)
77300Basic radiation dosimetry calculation, central axis depth dose calculation, TDF, NSD, gap calculation, off axis factor, tissue inhomogeneity factors, calculation of non-ionizing radiation surface and depth dose, as required during course of treatment, only when prescribed by the treating physician77403Radiation treatment delivery; single treatment area, single port or parallel opposed ports, simple blocks or no blocks;6-10 MeV77499Unlisted procedure, therapeutic radiology treatment management
77301Intensity modulated radiotherapy plan, including dose-volume histograms for target and critical structure partial tolerance specifications77404Radiation treatment delivery; single treatment area, single port or parallel opposed ports, simple blocks or no blocks;11-19 MeV77520Proton treatment delivery; simple, without compensation
77305Teletherapy, isodose plan (whether hand or computer calculated); simple (1 or 2 parallel opposed unmodified ports directed to a single area of interest)7740620 MeV or greater77522Proton treatment delivery, simple w/ compensation
77310Intermediate (3 or more treatment ports directed to a single area of interest)77407Radiation treatment delivery, 2 separate treatment areas, 3 or more ports on a single treatment area, use of multiple blocks; up to 5 MeV77523Proton treatment delivery, intermediate
77315Complex (mantle or inverted Y, tangential ports, the use of wedges, compensators, complex blocking, rotational beam, or special beam considerations)77408Radiation treatment delivery; two separate treatment areas, three or more ports on a single treatment area use of multiple blocks6-10 MeV77525Proton treatment delivery, complex
77321Special teletherapy port plan, particles, hemibody, total body77409Radiation treatment delivery; two separate treatment areas, three or more ports on a single treatment area use of multiple blocks11-19 MeVG0173Linear accelerator based stereotactic radiosurgery, complete course of therapy in one session
77326Brachytherapy isodose plan; simple (calculation made from single plane, 1 to 4 sources/ribbon application, remote afterloading brachytherapy, 1 to 8 sources)77411Radiation treatment delivery; two separate treatment areas, three or more ports on a single treatment area use of multiple blocks: 20 MeV or greaterG0251Linear accelerator based stereotactic radiosurgery, delivery including collimator changes and custom plugging, fractionated treatment, all lesions, per session, maximum five sessions per course of treatment
77327Intermediate (multiplane dosage calculations, application involving 5 to 10 sources/ribbons, remote afterloading brachytherapy, 9 to 12 sources)77412Radiation treatment delivery, 3 or more separate treatment areas, custom blocking, tangential ports, wedges, rotational beam, compensators, electron beam; up to 5 MeVG0339Image-guided robotic linear accelerator-based stereotactic radiosurgery, complete course of therapy in one session or first session of fractionated treatment
77328Complex (multiplane isodose plan, volume implant calculations, over 10 sources/ribbons used, special spatial reconstruction, remote afterloading brachytherapy, over 12 sources)77413Radiation treatment delivery; three or more separate treatment areas; custom blocking, tangential ports wedges, rotational beam, compensators, electron beam; 6-10 MV ComplexG0340Image-guided robotic linear accelerator-based stereotactic radiosurgery, delivery including collimator changes and custom plugging, fractionated treatment, all lesions, per session, second through fifth sessions, maximum five sessions per course of treatment
ICD-10 Codes
ICD-10DescriptionICD-10DescriptionICD-10Description
C50.919Malignant neoplasm of unspecified site of unspecified female breastC92.40Acute promyelocytic leukemia, not having achieved remissionD46.9Myelodysplastic syndrome, unspecified
C50.911Malignant neoplasm of unspecified site of right  female breastC92.50Acute myelomonocytic leukemia, not having achieved remissionD46.ZOther myelodysplastic syndromes
C50.912Malignant neoplasm of unspecified site of left female breastC92.60Acute myeloid leukemia with 11q23-abnormality not having achieved remission D69.3Immune thrombo cytopenic purpura
C50.921Malignant neoplasm of unspecified site of right male breastC92.A0Acute myeloid leukemia with multilineage dysplasia,not having achieved remissionD70.9Neutropenia, unspecified
C50.922Malignant neoplasm of unspecified site of left male breastZ31.5Encounter for genetic counselingD61.818Other pancytopenia
C50.929Malignant neoplasm of unspecified site of unspecified male breastC18.9Malignant neoplasm of colon, unspecifiedC91.00Acute lymphoblastic leukemia not having achieved remission
C34.90Malignant neoplasm of unspecified part of unspecified bronchus or lungC20Malignant neoplasm of rectumD47.2Monoclonal gammopathy
Z77.22Exposure to environmental tobacco smokeF43.23Adjustment disorder with mixed anxiety and depressed moodD89.2Hypergammaglobulinemia, unspecified
P96.81Exposure to tobacco smoke in the perinatal periodC61Malignant neoplasm of prostateM31.1Thrombotic micro angiopathy
Z87.891History of tobacco use126.99Other pulmonary emblism without acute cor pulmonaleC10.9Malignant neoplasm of oropharynx, unspecified
Z57.31Occupational exposure to environmental tobacco smoke126.09Other pulmonary embolism with acutew cor pulmonaleD45Polycythemia vera
Z72.0Tobacco use C43.9Malignant melanoma of skin, unspecifiedC22.1Intrahepatic bile duct carcinoma
C34.91Malignant neoplasm of unspecified part of right bronchus or lung D03.9Melanoma in situ, unspecifiedB16.-, B18.0-818.1Hepatitis B
C34.92Malignant neoplasm of unspecified part of left bronchus or lungC91.10Chronic lympocytic leukemia of B-cell type not having achieved remissionB17.1-, B18.2Hepatitis C
C85.80Other specified types of non-Hodgkin lymphoma, unspecified siteC71.9Malignant neoplasm of brain,unspecifiedC82.90Follicular lymphoma, unspecified, unspecified site
C85.89Other specified types of non-Hodgkin lymphoma,extranodal and solid organ sites197.2Postmastectomy lymphedema syndromeC82.99Follicular lymphoma, unspecified, extranodal and solid organ sites
C82.50Diffuse follicle center lymphoma, unspecified siteC15.9Malignant neoplasm of esophagus, unspecifiedC82.00Follicular lymphoma grade I, unspecified site
C82.59Diffuse follicle center lymphoma, extranodal and solid organ sites D69.6Thrombocytopenia,unspecifiedC82.09Follicular lymphoma grade I, extranodal and solid organ sites
C84.90Mature T/NK-cell lymphomas, unspecified, unspecified siteD64.9Anemia,UnspecifiedC82.10Follicular lymphoma grade II, unspecified site
C84.99Mature T/NK-cell lymphomas, unspecified, extranodal and solid organ sites182.409Acute embolism and thrombosis of unspecified deep veins of unspecified lower extremityC82.19Follicular lymphoma grade II, extranodal and solid organ sites
C84.A0Cutaneous T-cell lymphoma, unspecified, unspecified site182.401Acute embolism and thrombosis of unspecified deep veins of right lower extremityC82.20Follicular lymphoma grade III, unspecified, unspecified site
C84.A9Cutaneous T-cell lymphoma, unspecified, extranodal and solid organ sites182.402Acute embolism and thrombosis of unspecified deep veins of left lower extremityC82.29Follicular lymphoma grade III, unspecified, extranodal and solid organ sites
C84.Z0Other mature T/NK-cell lymphomas, unspecified site182.403Acute embolism and thrombosis of unspecified deep veins of lower extremity, bilateralC82.30Follicular lymphoma grade Illa, unspecified site
C84.Z9Other mature T/NK-cell lymphomas, extranodal and solid organ sitesC49.9Malignant neoplasm of connective and soft tissue,unspecifiedC82.39Follicular lymphoma grade Illa, extranodal and solid organ sites
C85.10Unspecified B-cell lymphoma, unspecified siteC47.9Malignant neoplasm of peripheral nerves and autonomic nervous system, unspecifiedC82.40Follicular lymphoma gradelllb, unspecified site
C85.19Unspecified B-cell lymphoma, extranodal and solid organ sitesC81.90Hodgkin lymphoma,unspecified,unspecified siteC82.49Follicular lymphoma gradelllb, extranodal and solid organ sites
C85.20Mediastinal (thymic) large B-cell lymphoma, unspecified siteC81.99Hodgkinlymphoma,unspecified,extranodal and solid organ sitesC82.60Cutaneous follicle center lymphoma, unspecified site
C85.29Mediastinal (thymic) large B-cell lymphoma, extranodal and solid organ sites189.0Lymphedema,not elsewhere classifiedC82.69Cutaneous follicle center lymphoma, extranodal and solid organ sites
C85.90Non-Hodgkin lymphoma, unspecified, unspecified siteC67.9Malignant neoplasm of bladder,unspecifiedC82.80Other types of follicular lymphoma, unspecified site
C85.99Non-Hodgkin lymphoma, unspecified, extranodal and solid organ sitesC64.9Malignant neoplasm of unspecified kidney, except renal pelvisC82.89Other types of follicular lymphoma, extranodal and solid organ sites
C86.4Blastic NK-cell lymphomaC64.1Malignant neoplasm of right kidney, except renal pelvisC90.01Multiple myeloma in remission
289.81Primary hypercoagulable stateC64.2Malignant neoplasm of left kidney, except renal pelvisC88.0Waldenstrom macroglobulinemia
D68.51Activated protein C resistanceD47.3Essential (hemorrhagic)thrombocythemiaC06.89Malignant neoplasm of overlapping sites of other parts of mouth
D68.52Prothrombin gene mutationZ51.11Encounter for antineoplastic chemotherapyC06.80Malignant neoplasm of overlapping sites of unspecified parts of mouth
D68.59Other primary thrombophiliaC62.10Malignant neoplasm of unspecified descended testisD59.0Drug-induced autoimmune hemolytic anemia
D68.61Antiphospholipid syndrome C62.90Malignant neoplasm of unspecified testis, unspecifiedD59.1Other autoimmune hemolytic anemias
D68.62Lupus anticoagulant syndromeC62.11Malignant neoplasm of descended right testisC83.39Diffuse large B-cell lymphoma, extranodal and solid organ sites
157.9Malignant neoplasm of pancreas, part unspecifiedC62.12Malignant neoplasm of descended left testisC85.20Mediastinal (thymic) large B-cell lymphoma, unspecified site
C25.9Malignant neoplasm of pancreas, unspecifiedC62.91Malignant neoplasm of right testis, unspecified whether descended or undescendedC85.29Mediastinal (thymic) large B-cell lymphoma, extranodal and solid organ sites
C90.00Multiple myeloma not having achieved remissionC62.92Malignant neoplasm of left testis, unspecified whether descended or undescendedC84.00Mycosis fungoides, unspecified site
C92.00Acute myeloblastic leukemia, not having achieved remissionD50.9Iron deficiency unspecified anemia, unspecifiedC84.09Mycosis fungoides, extranodal and solid organ sites
C92.10Chronic myeloid leukemia, BCR/ABL- positive, not having achieved remissionC16.9Malignant neoplasm of stomach, unspecifiedC32.9Malignant neoplasm of larynx, unspecified
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