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Official Description

Therapeutic radiology simulation-aided field setting; intermediate

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

Therapeutic radiology simulation-aided field setting is a crucial procedure in the field of radiation oncology, aimed at accurately identifying both normal and abnormal anatomical structures within the targeted treatment area. This process involves the acquisition of detailed images and data, which are essential for planning effective radiation therapy. During the simulation, a radiation oncologist or another qualified healthcare professional employs specialized simulation equipment, which may include dedicated simulators, radiation treatment units, or diagnostic X-ray machines. The primary goal of this procedure is to establish the optimal treatment position for the patient, ensuring that the radiation is delivered precisely to the intended area while minimizing exposure to surrounding healthy tissues. To achieve this, the healthcare provider may design and create immobilization devices tailored to the patient's needs, ensuring that the patient remains in a consistent position throughout the treatment. Additionally, localization lasers are utilized to align the patient accurately, and the skin may be marked with targeting markers or tattoos to facilitate precise targeting during subsequent treatment sessions. The simulation process also involves visualizing the radiation ports or fields in relation to anatomical landmarks, which is critical for effective treatment planning. Throughout the simulation, various parameters are meticulously documented, providing essential information that will guide the radiation therapy process. This procedure is categorized under CPT® Code 77285, which specifically denotes the simulation of three or more converging ports, two separate areas of interest, and the use of more than one block, distinguishing it from other related codes that describe less complex simulations.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The therapeutic radiology simulation-aided field setting is indicated for various clinical scenarios where precise localization of treatment areas is essential. The following conditions may warrant the use of this procedure:

  • Identification of Tumors: This procedure is performed to accurately locate and delineate tumors within the body, ensuring that radiation therapy targets the cancerous tissues effectively.
  • Assessment of Anatomical Structures: It is utilized to assess both normal and abnormal anatomical structures surrounding the treatment area, which is critical for planning radiation therapy.
  • Planning for Complex Treatment Techniques: The simulation is indicated when planning for complex treatment techniques that require precise alignment and positioning, such as the use of multiple radiation ports or advanced blocking techniques.

2. Procedure

The therapeutic radiology simulation-aided field setting involves several detailed procedural steps to ensure accurate treatment planning. Each step is critical for achieving optimal results:

  • Step 1: Equipment Setup The procedure begins with the setup of the simulation equipment, which may include dedicated simulators, radiation treatment units, or diagnostic X-ray machines. The healthcare professional ensures that all equipment is calibrated and functioning correctly to obtain high-quality images.
  • Step 2: Patient Positioning The patient is positioned on the simulation table, and immobilization devices may be designed and constructed as needed to maintain the patient's position throughout the simulation and subsequent treatments. This step is crucial for ensuring consistency in patient positioning.
  • Step 3: Use of Localization Lasers Localization lasers are employed to align the patient accurately with the treatment area. This alignment is essential for ensuring that the radiation is delivered precisely to the intended target.
  • Step 4: Marking the Skin The skin is marked with targeting markers or tattoos to provide visual references for the radiation therapy team. These markings help in maintaining the correct treatment position during future sessions.
  • Step 5: Visualization of Ports/Fields The healthcare professional visualizes the radiation ports or fields in relation to anatomical landmarks. This step is critical for planning the radiation delivery and ensuring that the treatment is effective.
  • Step 6: Documentation Finally, all parameters recorded during the simulation are meticulously documented. This documentation includes details about the patient's position, the equipment used, and any specific observations made during the simulation, which are essential for guiding the subsequent radiation therapy.

3. Post-Procedure

After the therapeutic radiology simulation-aided field setting, the patient may be monitored briefly to ensure that they are comfortable and to address any immediate concerns. The documentation generated during the procedure is reviewed and utilized to develop a comprehensive treatment plan tailored to the patient's specific needs. The healthcare team will discuss the next steps in the radiation therapy process with the patient, including scheduling future treatment sessions and any additional preparations that may be required. It is important for the patient to follow any instructions provided by the healthcare team to ensure the effectiveness of the upcoming treatments.

Short Descr THER RAD SIMULAJ FIELD INTRM
Medium Descr THER RAD SIMULAJ-AIDED FIELD SETTING INTERMED
Long Descr Therapeutic radiology simulation-aided field setting; intermediate
Status Code Active Code
Global Days XXX - Global Concept Does Not Apply
PC/TC Indicator (26, TC) 1 - Diagnostic Tests for Radiology Services
Multiple Procedures (51) 0 - No payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50) 0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 0 - Payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62) 0 - Co-surgeons not permitted for this procedure.
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Procedure or Service, Not Discounted when Multiple
ASC Payment Indicator Radiology service paid separately when provided integral to a surgical procedure on ASC list; payment based on OPPS relative payment weight.
Type of Service (TOS) 6 - Therapeutic Radiology
Berenson-Eggers TOS (BETOS) P7A - Oncology - radiation therapy
MUE 1
CCS Clinical Classification 211 - Therapeutic radiology
26 Professional component: certain procedures are a combination of a physician or other qualified health care professional component and a technical component. when the physician or other qualified health care professional component is reported separately, the service may be identified by adding modifier 26 to the usual procedure number.
59 Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25.
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
Q6 Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area
76 Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service.
79 Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.)
AQ Physician providing a service in an unlisted health professional shortage area (hpsa)
CR Catastrophe/disaster related
GC This service has been performed in part by a resident under the direction of a teaching physician
GV Attending physician not employed or paid under arrangement by the patient's hospice provider
GW Service not related to the hospice patient's terminal condition
Q1 Routine clinical service provided in a clinical research study that is in an approved clinical research study
TC Technical component; under certain circumstances, a charge may be made for the technical component alone; under those circumstances the technical component charge is identified by adding modifier 'tc' to the usual procedure number; technical component charges are institutional charges and not billed separately by physicians; however, portable x-ray suppliers only bill for technical component and should utilize modifier tc; the charge data from portable x-ray suppliers will then be used to build customary and prevailing profiles
X2 Continuous/focused services: for reporting services by clinicians whose expertise is needed for the ongoing management of a chronic disease or a condition that needs to be managed and followed with no planned endpoint to the relationship; reporting clinician service examples include but are not limited to: a rheumatologist taking care of the patient's rheumatoid arthritis longitudinally but not providing general primary care services
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
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2025-01-01 Changed Short Description changed.
Pre-1990 Added Code added.
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