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For 2015 radiation oncology medical practice management was thrown into a billing conundrum with the temporary “G” codes introduced by Medicare for radiation therapy treatment delivery and image guidance. 

 

Hospital based providers were told to use them, unless a commercial payer wanted the “77” codes.  Free-standing providers were directed to use the “77” codes unless a commercial payer wanted the “G” codes. 

Around and around it went.  We were told those temporary codes were just for a year, but here it is 2016 and we are still using them.

 

Then mid-2015, CMS decides that the 77290 initial simulation is covered under the IMRT treatment planning code 77301.  For billers that send out daily charges, new workflow procedures had to be implemented in order to not drop out a 77290 if there was going to be an upcoming 77301.

In keeping with the “bundling” movement, CMS has implemented a new 2016 CCI edit for 3D treatment planning code 77295 to include the basic dosimetry calculation 77300.

 

With the increasing use of HDR to treat skin cancers, we also have new HDR brachytherapy treatment codes:

77767:  Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed; lesion diameter up to 2.0 cm or 1 channel

77768:  lesion diameter over 2.0 CM and 2 or more channels, or multiple lesions

77770:  Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; 1 channel

77771: 2-12 channels

77772: over 12 channels

Deleted codes 77782-77784 are now represented by 77767-77768 and 77770-77772.

Deleted codes 77785-77787 are now represented by 77770-77772.

In a world where things are constantly changing, you need medical coding software you can rely on, contact Jonathan Morse at sales@iridiumsuite.com for more information.