Beginning January 1, 2010, prior approval is required when an FEP member has intensity modulated radiation therapy (IMRT). Call 800-782-4437 to obtain prior approval.
The codes requiring prior approval are:
- 77301 – intensity modulated radiotherapy plan, including dose-volume histograms for target and critical structure partial tolerance specifications
- 77338 – multi-leaf collimator (MLC) device(s) for intensity modulated radiation therapy (IMRT), design and construction per IMRT plan
- 77418 – intensity modulated treatment delivery, single or multiple fields/arcs, via narrow spatially and temporally modulated beams, binary, dynamic MLC, per treatment session.
- 0073T – compensator-based beam modulation treatment delivery of inverse planned treatment using 3 or more high resolution (milled or cast) compensator convergent beam modulated fields, per treatment session.
Complete FEP benefit information is available on the Web at
http://www.bcbsks.com/CustomerService/Providers/index.htm or call BCBSKS FEP customer service at 800-432-0379 or 785-291-4181.