Record and Verify Charge Capture: 2026 Code Crosswalk

Record and verify charge capture is where most radiation oncology charges are created. The treatment system, Varian’s Aria or Elekta’s Mosaiq in most departments, records each delivered fraction, each image and each device, attaches a billing code from a table, and sends the charge to the billing system over an interface. On January 1, 2026 many of the codes in those tables were deleted, and the treatment system did not update them automatically. If your 2026 remits carried CARC 181, “Procedure code was invalid on the date of service,” on delivery or guidance lines, this is the likely cause.

This is not a billing error. It is a table maintenance task that was not assigned to anyone, and it can be fixed in an afternoon.

Where the charge codes are stored

Siemens Healthineers, which now owns Varian, says ARIA “automatically captures codes for all completed activities using HCPCS, CPT and custom billing codes.” Elekta says billing data “can be captured in MOSAIQ and shared seamlessly with billing systems.” In both, an activity (a treatment session, an image, a device, a plan approval) is tied to a charge code in a table configured for your site, not supplied as a fixed code set. The vendor supplies the software; you maintain the codes in the table.

Menu names differ by version, so ask your system administrator where charge codes are maintained in your installation. You are looking for the list that says “this activity produces this code,” and the date it was last edited. If that date is before December 2025, the rest of this article applies to you.

Why the old codes do not map one to one

The old codes and the new ones measure different things. The deleted delivery codes were defined by the number of treatment areas and ports, the blocking, and the beam energy. The 2026 levels ignore energy and ignore whether the plan was 3D or IMRT: 77402 (Level 1) is electrons or single-isocenter 2D photons; 77407 (Level 2) is single-isocenter photons, 3D or IMRT; 77412 (Level 3) is multiple isocenters, or a single isocenter with active motion management, or total skin electrons, or mixed electron and photon fields. All three include image guidance when performed.

So a charge code that meant “three or more ports at 6 to 10 MeV” does not record the number of isocenters, which is what the 2026 code depends on. Any table that assigns a 2026 level from the old code alone will be wrong on some courses, and 77412 without a documented Level 3 criterion is likely to be downgraded.

The old codes do show which 2026 family a charge belongs to, and which lines should no longer exist at all:

2025 charge code	What it becomes in 2026
G6001, G6002, 77014 (image guidance)	77387-26 on the physician’s claim, nothing on the technical side: technical guidance is bundled into delivery in every setting
G6017 (intra-fraction tracking)	No line of its own; active motion management is a Level 3 criterion for the delivery code
G6003 to G6014, 77402 to 77416 (conventional delivery)	77402, 77407 or 77412, decided per plan from the isocenter count, motion management and beam type
G6015, G6016, 77385, 77386 (IMRT delivery)	77407 for a single isocenter without active motion management; 77412 with motion management or multiple isocenters
77417 (port films)	No charge; status B, no separate payment anywhere
77401 (superficial)	77437 or 77438; the new surface therapy family also has 77436 for planning and 77439 for ultrasound placement guidance

The decision in the third and fourth rows should be made by a person reading the plan, not by a default in the table.

The one-week review

Pull one week of imported charges from the billing system, every patient, every line, with the source charge code and the billed code side by side.
Flag any of the deleted codes: 77014, 77385, 77386, 77401 and G6001 to G6017. Each one is a row in the charge table that nobody edited.
Reconcile the counts. Fractions delivered should equal delivery lines (one per session) and 77387-26 lines (one per guided fraction); 77427 units should equal fractions divided by five, with three or four leftovers counting as a unit.
Rebuild the table above for your own charge codes, with a column that names who decides the level. For every delivery activity the answer should be a person reading the plan.
Name who maintains the charge master. In a freestanding center it is the practice. In a hospital-based arrangement the hospital owns the technical charges and the physician group the professional ones, and both must agree that 77387-26 goes to the physician’s claim and the delivery code to the hospital’s; see professional-only billing for hospital-based radiation oncologists.
Re-run the same week after the fix. If a deleted code still arrives, the activity was mapped in more than one place.

Freestanding or hospital: who fixes what

	Freestanding center	Hospital-based department
Treatment system charge table	The practice	The hospital (technical) and the physician group (professional), separately
Delivery lines 77402, 77407, 77412	The practice’s global claim	The hospital’s outpatient claim only
77387-26	The practice, with 26 even though everything else is global	The physician’s claim
Level decision	Dosimetry or physician, per plan	Same, and both claims must agree on the level

What to do now

Open the charge table this week and note the last-edited date.
Deactivate deleted code rows rather than remapping them with no record, so what was billed in 2025 stays readable.
Assign the level decision to a person. A plan note naming the isocenter count and any motion management supports the delivery code, the authorization and any downgrade appeal.
Confirm 77387 produces a 26 line to the physician in both settings, and that no technical guidance charge remains.
Check the import, not just the table. Iridium Suite’s Record & Verify import brings charges in from Aria and Mosaiq and the claim scrubber warns when an imported charge carries a deleted 2026 code, but the practice must still maintain the charge codes in the R&V system; see Record & Verify integration and the claim scrubber.
Repeat the review each January.

Record and Verify charge capture after the 2026 code change: mapping Aria and Mosaiq charges to 77402, 77407, 77412 and 77387-26