An Innovative Approach to Osteoarthritis Treatment and Its Implications for Oncology Billing

Osteoarthritis (OA) affects millions worldwide, leading to chronic pain, limited mobility, and decreased quality of life. While traditional treatments such as physical therapy, medications, and surgery remain common, radiation therapy (RT) is increasingly being adopted for the treatment of osteoarthritis (OA), providing promising relief of symptoms. Though not common in the United States, the concept of low-dose radiation to treat osteoarthritis has been around for decades. Incorporating RT for OA treatment in the United States presents new opportunities for patient care and introduces complexities in oncology billing practices. ​

Understanding Radiation Therapy in Osteoarthritis 

Radiation therapy, widely known for its role in cancer treatment, has also been found effective in managing certain benign conditions. RT for OA involves low-dose radiation targeting inflamed joints, aiming to reduce inflammation and alleviate pain (1). The mechanism of RT’s efficacy lies in its ability to modulate inflammatory pathways, resulting in symptom relief for many patients (2). ​

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Clinical Evidence Supporting RT for OA  

Numerous studies highlight the benefits of RT for OA patients. For example, a randomized double-blind trial demonstrated significant pain reduction and functional improvement in patients treated with low-dose RT compared to placebo (2). Similarly, European clinical practices frequently employ RT for OA, reporting high patient satisfaction and minimal side effects (3). The article by Ansari et al. further highlights these findings offering a comprehensive review of RT’s safety and efficacy in OA treatment (4). ​​

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Safety and Side Effects 

RT for OA is generally well-tolerated with studies reporting minimal adverse effects compared to traditional treatments, such as NSAIDs or corticosteroids (2, 4). The precise dosing and localized application reduce risks making it an attractive option for patients seeking non-invasive alternatives. To ensure optimal outcomes though, healthcare providers must monitor patients closely. ​

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Current Utilization and Acceptance  

Despite its promising results, RT for OA remains underutilized in the United States. In Europe, RT is well-integrated into treatment protocols for OA and other benign conditions (3). In the United States, its limited adoption may stem from differences in clinical guidelines and insurance reimbursement policies. This discrepancy presents both challenges and opportunities for oncology billing professionals to navigate coding and coverage nuances. ​

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Implications for Oncology Billing 

Applying RT for non-malignant conditions like OA introduces unique considerations for oncology billing. Proper coding is essential to ensure compliance and reimbursement. Since there are currently no specific procedure codes for these conditions, reimbursement is highly payer-specific in these cases. As previously stated, these conditions are not yet widely covered in the United States, so careful review of payer policy and strong justification for using the treatment is recommended (3). Additionally, educating providers and payers about RT’s clinical benefits can support claims and reduce denials. ​

For instance, aligning documentation with payer policies is critical. Detailed records of patient diagnosis, treatment rationale, and outcomes can strengthen claims (1, 4). Oncology billing teams must also remain vigilant about regulatory changes, particularly as more evidence emerges supporting RT for OA. ​

Radiation therapy represents a promising and effective treatment option for osteoarthritis in the United States offering hope to patients with chronic joint pain. As its use expands, oncology billing professionals must address the associated complexities to ensure successful reimbursement and compliance. By staying informed about clinical advancements and adapting billing strategies, healthcare providers and billing teams can collaborate to make this useful therapy more accessible to patients in need. ​

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Sources:

• ​1.)  Fionda, B., Lancellotta, V., Casà, C., Boldrini, L., et al. (2021). Radiotherapy for benign disorders: Current use in clinical practice. European Review of Medical and Pharmacological Sciences, 25(9), 3440-3443. https://doi.org/10.26355/eurrev_202105_25824 

• 2.)  Mahler EAM, Minten MJ, Leseman-Hoogenboom MM, et al. (2019). Effectiveness of low-dose radiation therapy on symptoms in patients with knee osteoarthritis: a randomised, double-blinded, sham-controlled trial. Annals of the Rheumatic Diseases, 78:83-90. https://ard.bmj.com/content/78/1/83  
• 3.)  Taylor, R.E., Hatfield, P., McKeown, S.R., et al. (2015). Radiotherapy for benign disease: Current evidence and new perspectives. Clinical Oncology, 27(8), 433-435. https://www.clinicaloncologyonline.net/article/S0936-6555%2815%2900033-3/fulltext  
• 4.)  Yu, J. B., Grew, D. J., Spraker, M. B., et al. (2025). Radiation Therapy for the Treatment of Osteoarthritis. Practical radiation oncology, 15(1), 19–24. https://doi.org/10.1016/j.prro.2024.09.003