CommercialCoverageMedium impact
Intraoperative Radiotherapy
Blue Cross & Blue Shield of Mississippi·MS · Oncology, General Surgery, Radiology·Medical Policy
We identified it
Jun 20, 2026
Summary
This policy defines coverage for Intraoperative Radiotherapy (IORT), which is only considered medically necessary for rectal cancer with positive/close margins in T4 lesions or recurrent disease. All other oncologic applications of IORT are considered investigational and not covered.
Action Required
Billing team must ensure IORT procedures (CPT 0735T, 77425, 77469) are only billed for rectal cancer patients with positive/close margins in T4 lesions or recurrent disease. Verify diagnosis codes C20, C78.5 are documented. All other oncologic IORT applications will be denied as investigational.