# CT Guid radiation therapy aka CT SIM



## RADCODER (May 14, 2009)

*We are subcontracted with a hospital and do the professional readings of X-rays, CT's, US, etc.. we are wondering if it is appropriate to be billing out 77014 -26(CT Guid radiation therapy fields)? They are done for non-diagnostic purposes and for radiation planning only. Does anyone else bill for this? Any and all suggestions are welcomed. Below is an example of a report one of our Rad's dictated....

Thank you,
Jessica*

CT SIMULATION:

HISTORY: Radiation therapy planning for breast cancer.

Axial images of the chest are obtained without intravenous contrast, as radiation therapy planning for breast cancer.

A port catheter is projected over the right upper chest wall, with the tip of the port catheter within the superior vena cava. There is a normal appearance to the great vessels. Heart size is
normal. There is no pericardial effusion or basilar pleural effusion. There is no mediastinal mass or gross lymphadenopathy within the chest. It is difficult to evaluate the hili without IV contrast,
although no bulky hilar lymphadenopathy is identified. Bilateral breast implants are present. There are shotty bilateral axillary lymph nodes. Several surgical clips are identified in the left axilla,
likely from prior left axillary lymph node resection surgery.

Only small portions of the adrenal glands are visualized; no abnormality is detected.

Bone windows demonstrate degenerative changes of the spine. No destructive bone lesion is identified.

Lung windows reveal non-specific bibasilar gradational atelectasis. There is no peripheral pulmonary nodule, mass, pneumonia, or pleural effusion. Motion artifact degrades the fine lung detail
and limits evaluation.

IMPRESSION:

1.  Status-post left axillary surgery with bilateral breast prostheses and Mediport catheter noted.

2.  No mediastinal mass or gross lymphadenopathy within the chest.

3.  Non-specific bibasilar gravitational atelectasis.


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## birky (May 14, 2009)

*77014-26*

Our office is also sub-contracted with the hospital, and we bill 77014,26 for CT guided rad therapy.


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## RADCODER (May 14, 2009)

Thanks Jenny. I am going to try to get as many responses as I can and see what the average is. Just not too sure if we should leave this up to the oncologist alone or if we have the right to bill as well.


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## prabha (May 15, 2009)

Hi,

I also get these kind of reports often,but we would bill for CT of the respective anatomical area(in this case - 71250-26) since 77014-26 is a code which an Radiation Oncologist would bill.Hope this helps.


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## RADCODER (May 15, 2009)

Thanks Prabha.. so far it's 1 vs 1.


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