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Radiation Oncology Certified Coder ROCC EXAM
LATEST VERSION 2026-2027 QUESTIONS WITH
CORRECT SOLUTIONS ALL WITH DETAILED
RATIONALES JUST RELEASED THIS YEAR
SUMMARIZED EXAM COVERAGE
The Radiation Oncology Certified Coder (ROCC) exam, offered by AMAC through Pearson VUE,
is a two-hour, 150-question multiple-choice assessment. It covers coding and compliance for all
radiation oncology modalities, evaluation and management (E/M) services, Medicare policies,
and regulatory requirements. Candidates may use the ICD-10-CM, CPT, and HCPCS manuals, the
ROCC Study Guide, and the ASTRO/ACR Guide to Radiation Oncology Coding as reference
materials. The certification is valid for two years and requires 12 CEUs (with 6 ROCC-issued) for
recertification.
300 RANDOMIZED PRACTICE QUESTIONS (MCQ) WITH ANSWERS AND ITALICIZED RATIONALES
QUESTION 1
A 68-year-old patient with localized prostate cancer receives intensity-modulated radiation
therapy (IMRT) delivered over 28 fractions. The radiation oncologist documents daily review of
on-board imaging, adjustment of treatment fields based on target motion, and verification of
isocenter alignment before each fraction. What code(s) should be reported for the image
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guidance performed during each treatment session?
A) 77387
B) 77014
C) G6001
D) 77427
Answer: B
CPT 77014 (computed tomography guidance for radiation therapy delivery) is used for CT-based
image guidance, including daily target localization. 77387 (guidance for localization, each
session) is more appropriate for ultrasound guidance. G6001 is not a valid code for daily CT
guidance. 77427 represents weekly treatment management, not daily imaging.
QUESTION 2
A patient with early-stage laryngeal cancer receives definitive radiation therapy with 3-D
conformal planning. The physician spends 75 minutes reviewing the 3-D dose distribution,
evaluating non-coplanar beams, and approving the digitally reconstructed radiographs (DRRs).
What is the correct simulation code?
A) 77280
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B) 77261
C) 77295
D) 77263
Answer: C
CPT 77295 (therapeutic radiology simulation-aided field setting; complex) is appropriate when
3-D treatment planning and non-axial beam arrangements are utilized. 77280 and 77281
represent simple and intermediate simulation, respectively. 77263 is a treatment planning code.
77295 includes review of 3-D dose distributions, DRRs, and non-axial beams.
QUESTION 3
During a chart audit, you discover that a radiation oncologist documented a “weekly treatment
management” service for a patient receiving palliative radiation to a painful bone metastasis.
The patient received only two fractions of treatment total. Can 77427 be billed?
A) Yes, weekly management can be billed for any full week of treatment.
B) Yes, because the patient received at least one fraction.
C) No, because a minimum of five fractions is required to bill 77427.
D) No, because the global period for palliative treatment is 0 days.
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Answer: C
CPT 77427 (radiation treatment management, weekly) requires that the patient receive at least
five fractions of radiation during the service week. With only two fractions, weekly management
cannot be reported.
QUESTION 4
A patient with a brain metastasis receives a single fraction of stereotactic radiosurgery (SRS)
using a Gamma Knife unit. The neurosurgeon and radiation oncologist both participate in target
delineation, dose prescription, and treatment delivery. What modifier should be appended to
the SRS delivery code to indicate that both physicians contributed to planning and delivery?
A) Modifier 62
B) Modifier 80
C) Modifier 52
D) Modifier 66
Answer: A
Modifier 62 (two surgeons) is used when two or more physicians (e.g., neurosurgeon and
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SUCCESS!
Radiation Oncology Certified Coder ROCC EXAM
LATEST VERSION 2026-2027 QUESTIONS WITH
CORRECT SOLUTIONS ALL WITH DETAILED
RATIONALES JUST RELEASED THIS YEAR
SUMMARIZED EXAM COVERAGE
The Radiation Oncology Certified Coder (ROCC) exam, offered by AMAC through Pearson VUE,
is a two-hour, 150-question multiple-choice assessment. It covers coding and compliance for all
radiation oncology modalities, evaluation and management (E/M) services, Medicare policies,
and regulatory requirements. Candidates may use the ICD-10-CM, CPT, and HCPCS manuals, the
ROCC Study Guide, and the ASTRO/ACR Guide to Radiation Oncology Coding as reference
materials. The certification is valid for two years and requires 12 CEUs (with 6 ROCC-issued) for
recertification.
300 RANDOMIZED PRACTICE QUESTIONS (MCQ) WITH ANSWERS AND ITALICIZED RATIONALES
QUESTION 1
A 68-year-old patient with localized prostate cancer receives intensity-modulated radiation
therapy (IMRT) delivered over 28 fractions. The radiation oncologist documents daily review of
on-board imaging, adjustment of treatment fields based on target motion, and verification of
isocenter alignment before each fraction. What code(s) should be reported for the image
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guidance performed during each treatment session?
A) 77387
B) 77014
C) G6001
D) 77427
Answer: B
CPT 77014 (computed tomography guidance for radiation therapy delivery) is used for CT-based
image guidance, including daily target localization. 77387 (guidance for localization, each
session) is more appropriate for ultrasound guidance. G6001 is not a valid code for daily CT
guidance. 77427 represents weekly treatment management, not daily imaging.
QUESTION 2
A patient with early-stage laryngeal cancer receives definitive radiation therapy with 3-D
conformal planning. The physician spends 75 minutes reviewing the 3-D dose distribution,
evaluating non-coplanar beams, and approving the digitally reconstructed radiographs (DRRs).
What is the correct simulation code?
A) 77280
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B) 77261
C) 77295
D) 77263
Answer: C
CPT 77295 (therapeutic radiology simulation-aided field setting; complex) is appropriate when
3-D treatment planning and non-axial beam arrangements are utilized. 77280 and 77281
represent simple and intermediate simulation, respectively. 77263 is a treatment planning code.
77295 includes review of 3-D dose distributions, DRRs, and non-axial beams.
QUESTION 3
During a chart audit, you discover that a radiation oncologist documented a “weekly treatment
management” service for a patient receiving palliative radiation to a painful bone metastasis.
The patient received only two fractions of treatment total. Can 77427 be billed?
A) Yes, weekly management can be billed for any full week of treatment.
B) Yes, because the patient received at least one fraction.
C) No, because a minimum of five fractions is required to bill 77427.
D) No, because the global period for palliative treatment is 0 days.
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Answer: C
CPT 77427 (radiation treatment management, weekly) requires that the patient receive at least
five fractions of radiation during the service week. With only two fractions, weekly management
cannot be reported.
QUESTION 4
A patient with a brain metastasis receives a single fraction of stereotactic radiosurgery (SRS)
using a Gamma Knife unit. The neurosurgeon and radiation oncologist both participate in target
delineation, dose prescription, and treatment delivery. What modifier should be appended to
the SRS delivery code to indicate that both physicians contributed to planning and delivery?
A) Modifier 62
B) Modifier 80
C) Modifier 52
D) Modifier 66
Answer: A
Modifier 62 (two surgeons) is used when two or more physicians (e.g., neurosurgeon and
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