Wiki 77290 Complex Simulation

Hello,

Can anyone please help

a simulation is characterized as complex if any of the following criteria are met: particle beam, rotation or arc therapy, complex or custom blocking, brachytherapy simulation, hyperthermia probe verification, or any use of contrast material. If these criteria are not met, then the complexity is determined by the number of treatment areas: one treatment area is considered simple, two treatment areas are considered intermediate, and three or more treatment areas are considered complex.

Does this mean particle beam, rotation or arc therapy, complex or custom blocking should be done the same time as the simulation?

And where do we get documentation for particle beam, rotation or arc therapy, complex or custom blocking should be done the same time as the simulation?

Thank you

debi_broone89@yahoo.com said:

Hello,

Can anyone please help

a simulation is characterized as complex if any of the following criteria are met: particle beam, rotation or arc therapy, complex or custom blocking, brachytherapy simulation, hyperthermia probe verification, or any use of contrast material. If these criteria are not met, then the complexity is determined by the number of treatment areas: one treatment area is considered simple, two treatment areas are considered intermediate, and three or more treatment areas are considered complex.

Does this mean particle beam, rotation or arc therapy, complex or custom blocking should be done the same time as the simulation?

And where do we get documentation for particle beam, rotation or arc therapy, complex or custom blocking should be done the same time as the simulation?

Thank you

Click to expand...

Simulation is part of preparting for treatment. In the simulation, you're trying to position the patient exactly as they will be during treatment delivery. It's a check to ensure how to position the patient and line up the anotomical structures, so that treatment can be delivered safely.

Any blocking or positioning devices that will be used during treatment should be used during the simulation. The whole purpose of the simulation is to replicate exactly what will happen during treatment delivery, minus the radiation.

The bullet points for Particle therapy and Rotation or arc therapy refer to the method of treatment delivery. For example, if the simulation was in preparation for a course of proton therapy, then it would be complex. The treatment isn't actually being delivered during the simulation - it just refers to what method of treatment the simulation is preparing the patient for.




ASTRO has some Coding FAQs and Tips on the website: https://www.astro.org/practice-support/reimbursement/coding/coding-guidance/coding-faqs-and-tips

Then, if the patient is going to be treated with VMAT, I can then code sim as complex?
Follow up question, do u consider MLC as complex blocking or custom shielding blocks?