Prior Auth Required

77306 - Teletherapy isodose plan; simple (1 or 2 unmodified ports directed to a single area of interest), includes basic

This procedure appears on the selected insurer prior authorization source.

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Prior authorizationPrior Auth Required
Procedure / ServiceTeletherapy isodose plan; simple (1 or 2 unmodified ports directed to a single area of interest), includes basic
Procedure / Service Description

Code NAME/DESCRIPTION COMMENTS - 77301 Intensity modulated radiotherapy plan, including dose-volume histograms for target and critical structure partial tolerance specifications 77306 Teletherapy isodose plan; simple (1 or 2 unmodified ports directed to a single area of interest), includes basic dosimetry calculation(s) 77307 Teletherapy isodose plan; complex (multiple treatment areas, tangential ports, the use of wedges, blocking,

Likely documents
  • Confirm benefit details
  • Submit clinical notes if requested by the plan
Next actions
  • Confirm the current plan policy before submission.
  • Use the insurer authorization workflow for this listed code.