Special teletherapy port plan, particles, hemi-body, total body uses CPT code 77321. Only one plan should be billed per treatment course.
Full Answer
How many times can an IMRT plan be billable during therapy?
An IMRT plan (CPT® 77301) is billable only one time during a course of therapy. In rare cases, billing a second IMRT plan during the same course of therapy may be warranted. In this scenario, planning from
What is the CPT code for radiation therapy delivery?
Use CPT code 77401 for radiation treatment delivery, superficial and/or ortho voltage per day. Do not report clinical treatment planning (77261, 77262, 77263), treatment devices (77332, 77333, 77334), isodose planning (77306, 77307), physics consultation (77336), or treatment management (77427, 77431, 77470) with 77401.
How many times can CPT 77331 be billable?
CPT® 77331 is billable once per port/field/angle, per course of 2D or 3D external beam radiation therapy only when medically necessary and ordered by a radiation oncologist.
What is the CPT code for Radiation Physics consultation?
Use CPT code 77336for continuing medical radiation physics consultation, including assessment of treatment parameters, quality assurance of dose delivery, and review of patient treatment documentation in support of the radiation oncologist, reported per week of therapy (once every consecutive five treatments delivered).
How many times can you bill 77300?
Basic dosimetry calculations (CPT code 77300) may be reported as many times as the calculations are performed. The typical course of radiation therapy will require from one to six dosimetry calculations, depending on the complexity of the patient's problem.
How many times can you bill 77280?
Only 1 verification simulation is allowed per phase of treatment. For HDR brachytherapy treatments, one (1) verification simulation (CPT® 77280) may be approved per treatment. Additional services may be requested and will be reviewed for medical necessity based on individual patient circumstances.
How many times can you bill 77334?
CPT code 77334 is typically billed multiple times (often on the same day of service), once for each of the separate IMRT fields as required by the plan during the course of IMRT treatment. The typical case will require up to ten (10) devices.
How many times can you bill 77263?
77263 is only billable once per course of treatment.
How many times can you bill 77338?
Standards for CPT® 77338 CPT® 77338 may only be billed one (1) time per IMRT plan created. other type of isodose planning. In the event of an IMRT boost, the treatment device is allowed even though the additional plan may not be allowed.
How is radiation therapy billed?
CPT® codes 77370 and 77470 are used to report the additional time and effort required when a medical physicist and radiation oncologist must plan for and deliver treatment under unusual clinical circumstances. Neither code should be billed routinely in connection with usual and customary services.
How often can you bill 77336?
weekly77336 Continuing medical physics consultation, including assessment of treatment parameters, quality assurance of dose delivery, and review of patient treatment documentation in support of the prescription, reported once per each 5 fractions of therapy. This is commonly referred to as “weekly physics”.
What does CPT code 77334 mean?
Coding Answer: CPT code 77334-TC, Treatment Devices, Design and Construction; Complex, is used to report the work of creating the MLC delivery pattern for each unique deliverable treatment field.
What is the global period for radiation therapy?
Phone calls during treatment are included in the work captured in CPT code 77427, which includes a 90-day global period after treatment is completed, and therefore CPT codes 99441 – 99443 cannot be billed separately during this time.
What is procedure code 77263?
Clinical treatment planning codes (CPT codes 77261-77263) are the professional charges for the physician to integrate the patient's overall medical condition and extent of disease and to formulate a plan of therapy for the patient.
What is the difference between 77385 and 77386?
CPT 77385 is often appropriate for breast or prostate cancer diagnoses because critical structures are not in the immediate area. CPT 77386 may be appropriate for the left breast, depending on the location of the tumor and what tissues may be impacted.
What is the difference between 77014 and 77387?
Networker. Since you are in a hospital you will follow the AMA codes for Medicare patients for the technical services. Your IGRT code is 77387 for the technical component billed by the hospital. If you are billing for the treatment planning CT at time of simulation, you will bill 77014-TC which you were doing in 2014.
Is treatment planning a one time charge?
A. Treatment planning is a one-time charge per course of therapy. Billing for multiple treatment plans for a single course of treatment is not allowed. This is a professional service only and the physician is responsible for all the technical aspects of the treatment planning process.
Is excessive frequency considered medically necessary?
Frequency is considered excessive when services are performed more frequently than generally accepted by pe ers and the reason for additional services is not justified by documentation.
What is a special teletherapy port?
A special teletherapy port plan is a dosimetry plan and must NOT be billed in addition to another dosimetry plan (CPT® 77306-77307, 77295, 77301) for the same work performed.
Is CPT 77306 billable?
Monitor unit calculations are not billable with CPT® 77306, 77307 and 77321. Calculations are considered bundled into these planning codes and not separately billable.
What is IMRT radiation?
IMRT is a type of external beam radiation therapy that delivers highly conformal, 3-D radiation treatment. It typically includes inverse planning, and features numerousbeams of radiation involving multiple targets with different doses, intended to maximize the dose to the tumor and minimize the dose to normal tissue. The difference between
What is the code for ultrasound guidance?
Ultrasound guidance for field placement, code 76950, is currently the code used most often for verifying precise targeting for daily treatment. Other image guidance may include implanted marker seeds, CT and portal imaging systems, and a variety of codes from CT localization to simple simulation are being reported. New guidance code(s) are in development. Additional discussion to follow.
What is SRS in radiology?
SRS – Stereotactic radiosurgery was initially usedonly to treat intra-cranial lesions. Multiple beams converge on the target with 3-D planning, producing a much higher dose, usually in one session. Treatment may be delivered via gamma ray (GammaKnife) using a head chamber, or via a linear accelerator using a head frame applied by a neurosurgeon, and fiducial markers for accurate delivery.
How long does APBI treatment last?
APBI differs from whole breast external beam radiation therapy in several ways. Treatment is delivered via HDR brachytherapy. The radiation targets only a segment surrounding the tumor rather than the entire breast. Since the duration of treatment is 4 to 5 days rather than 5 to 6 weeks, radiation is delivered in fewer fractions at larger doses per fraction. APBI features:
What is TomoTherapy Hi Art System?
It combines planning, patient positioning and treatment delivery into one system . Radiation is delivered in a unique helical (or spiral) delivery pattern which travels in multiple circles all the way around the gantry ring. The patient's couch also moves, guiding the beam at slightly different planes during treatment.
How many phases are there in radiation oncology?
The process of care in radiation oncology is a series of complex steps that can be broken down into six phases: Patient consultation; Preparing for treatment; Medical radiation physics, dosimetry, treatment devices and special services; Radiation treatment delivery;
What is simulation in radiation?
Simulation is the process of defining relevant normal and abnormal target anatomy and acquiring the images and data necessary to develop the optimal radiation treatment process, without actually delivering a treatment.
What is CPT code 77261?
Clinical treatment planning codes (CPT codes 77261-77263) are the professional charges for the physician to integrate the patient’s overall medical condition and extent of disease and to formulate a plan of therapy for the patient.
What is the role of radiation oncologist?
Within clinical treatment planning, the radiation oncologist develops the specific parameters of the therapeutic management plan, including the overall clinical, physical and technical aspects of radiation treatment required for safe and effective therapy for each patient .
Is 77293 reimbursable?
In the hospital setting under the Hospital Outpatient Prospective Payment System (HOPPS), +77293 is not separately reimbursable. However, it is extremely important to still report +77293 (when performed) separately for tracking purposes and for non-governmental payers that may not conform to HOPPS guidelines.
What is CPT code 77300?
Radiation physics services (CPT codes 77300-77334, 77399) include a professional component (PC) and a technical component (TC). These services are covered following the same logic as other radiologic services that include PC and TC components.
What is the XVIII section of the Social Security Act?
This section allows coverage and payment of those services that are considered to be medically reasonable and necessary.
Is excessive frequency considered medically necessary?
Frequency is considered excessive when services are performed more frequently than generally accepted by pe ers and the reason for additional services is not justified by documentation.