I prefer starting with the bad news. 
CMS was unable to make up their mind on new treatment delivery codes that were supposed to take effect in 2015.
As their interim solution, they have decided that hospital radiation services will utilize some “redefined” existing CPTS.
2014 CPT 2015 CPT
77402
77403 77402
77404
77406
77407
77408 77407
77409
77411
77412
77413 77412
77414
77416
If they were using the same process for freestanding centers, there would be much less confusion, but instead they are requiring the use of temporary G codes.
When you throw commercial payers into the mix, the confusion is compounded. Some of those may want to see the CPTs instead of the G codes. The bad news, it got worse.
2014 CPT 2015 G-Codes
77402 G6003
77403 G6004
77404 G6005
77406 G6006
77407 G6007
77408 G6008
77409 G6009
77411 G6010
77412 G6011
77413 G6012
77414 G6013
77416 G6014
77418 G6015
Now it’s time for the good news. The crack team of software developers at Medical Business Systems has created several tools that Iridium Suite medical billing software users are very excited about.
For hospital based clients, the system will recognize the 2015 CPTs and provide replacement options to the professional G-Codes.
If any inactive 2014 CPTs are entered in error, the user is warned. This allows the opportunity to correct the claim before it is sent to the payer and denied.
To accommodate the potential that commercial payers will require CPTs instead of G-Codes, an innovative “crosswalk” tool was created to generate charges to specific payers meeting their individual requirements.
At Medical Business Systems, our philosophy is to always “work smarter, not harder”. Give us the opportunity to show you how we can help you!
