Superficial RT

[deleted1111261]

Hi, I'm a radiation oncologist and fascinated with dermatology's foray into our world 🙂

Curious about something -

How/why would you bill a simulation (77280) charge every treatment and IGRT (G6001) for every treatment for a superficial lesion?

Is there a clinical need? Does the plan change daily?

I've treated with EBRT for years. We do one plan and no image guidance (well, we do use our eyes) and the outcomes are excellent.

Is there any literature that daily planning and IGRT improve outcomes?

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[doctalaughs]

Hi, I'm a radiation oncologist and fascinated with dermatology's foray into our world 🙂

Curious about something -

How/why would you bill a simulation (77280) charge every treatment and IGRT (G6001) for every treatment for a superficial lesion?

Is there a clinical need? Does the plan change daily?

I've treated with EBRT for years. We do one plan and no image guidance (well, we do use our eyes) and the outcomes are excellent.

Is there any literature that daily planning and IGRT improve outcomes?

No idea — as I still think the vast majority of dermatologists still haven’t bought into the idea that superficial radiation is a mainstream derm thing.

For the few that do it regularly - I’d be interested in also hearing their logic why they do it (as opposed to referring) when the volume of tumors that are appropriate compared with other modalities seems minuscule.

 

[Slack3r]

No idea — as I still think the vast majority of dermatologists still haven’t bought into the idea that superficial radiation is a mainstream derm thing.

For the few that do it regularly - I’d be interested in also hearing their logic why they do it (as opposed to referring) when the volume of tumors that are appropriate compared with other modalities seems minuscule.

I think we all know the an$wer to that que$tion.

 

[werd]

i did superficial radiation therapy for a while, and did it the way that you describe - no imaging and one plan. we also had very good outcomes in general.
in terms of why we started offering it, we thought it would be a good option for patients with surgery fatigue or who were otherwise poor candidates for excision/Mohs. it was, and quite a few patients were really grateful that we offered it. but the volume of patients that we ended up treating with SRT wasn't very high.

 

[MOHS_01]

Hi, I'm a radiation oncologist and fascinated with dermatology's foray into our world 🙂

Curious about something -

How/why would you bill a simulation (77280) charge every treatment and IGRT (G6001) for every treatment for a superficial lesion?

Is there a clinical need? Does the plan change daily?

I've treated with EBRT for years. We do one plan and no image guidance (well, we do use our eyes) and the outcomes are excellent.

Is there any literature that daily planning and IGRT improve outcomes?

This is a question for the company who is promoting this... and their lawyers. It is on the radar and is not viewed favorably by those in derm looking into it.

You may want to query ASTRO and their RUC team prior to stirring any pots or kicking any nests.

 

[MOHS_01]

i did superficial radiation therapy for a while, and did it the way that you describe - no imaging and one plan. we also had very good outcomes in general.
in terms of why we started offering it, we thought it would be a good option for patients with surgery fatigue or who were otherwise poor candidates for excision/Mohs. it was, and quite a few patients were really grateful that we offered it. but the volume of patients that we ended up treating with SRT wasn't very high.

As time goes by it's true utility becomes more apparent and the financial case for most practices becomes much less green than the promises of the manufacturer or services companies.

(unless you're in The Villages or some **** -- then your mileage may vary)