Oncology & Hematology Coding Alert

Plus: CPT 2007 takes time limits off some chemo codes

Good news: Instead of the two current category III codes for stereotactic body radiation therapy (0082T-0083T), you-ll finally have new CPT codes:

- 77371  Radiation treatment delivery, stereotactic radiosurgery (SRS), complete course of treatment of cerebral lesion(s) consisting of 1 session; multi-source Cobalt 60 based      
                                     
- 77372 --  - linear accelerator based

- 77373 -- Stereotactic body radiation therapy, treatment delivery, per fraction to 1 or more lesions, including image guidance, entire course not to exceed 5 fractions 

- 77435 -- Stereotactic body radiation therapy, treatment management, per treatment course, to one or more lesions, including image guidance, entire course not to exceed 5 fractions.

Red flag: -Codes 77373 and 77435 specifically state that the entire course is not to exceed five fractions when using these codes. This means that if the planned course of treatment is 15 fractions,- you must not use these codes, says Cindy Parman, CPC, CPC-H, RCC, co-owner of Coding Strategies Inc. in Powder Springs, Ga., and president of the American Academy of Professional Coders National Advisory Board.
       
You-ll also have some code changes for prostate procedures -- use 55875 (Transperineal placement of needles or catheters into prostate for interstitial radioelement application, with or without cystoscopy) instead of 55859.

You-ll also finally have a separate code for placement of devices such as fiducial markers -- 55876 (Placement of interstitial device[s] for radiation therapy guidance [e.g., fiducial markers, dosimeter], prostate [via needle, any approach], single or multiple).

Don't Rely on Your Memory of 2006 Codes in 2007

More changes: You can no longer assume that a 77xxx code is specific to radiation oncology. CPT changes the codes assigned to services such as bone studies, mammo-graphy, and CT and MR guidance.

Example: CPT 2007 changes the codes for computed tomography and magnetic resonance needle-placement guidance:

2006          2007            Descriptor
76360        77012          Computed tomography guidance for needle placement (e.g., biopsy, aspiration, injection, localization device), radiological supervision and interpretation

76393        77021          Magnetic resonance guidance for needle placement (e.g., for biopsy, needle aspiration, injection,  localization device), radiological  supervision and interpretation

These codes -represent two ways of accomplishing needle placement that previously was done under fluoroscopic guidance,- says Susan Vogelberger, CPC, CPC-H, CMBS, owner and president of Healthcare Consulting & Coding Education in Boardman, Ohio.

Be Sure You Catch These Revisions

CPT 2007 revises two chemotherapy add-on codes:

- 96415 -- Chemotherapy administration, intravenous infusion technique; each additional hour (list separately in addition to code for primary procedure).

Change: CPT 2007 removes the phrase -1 to 8 hours- from code 96415.

- 96423 -- Chemotherapy administration, intra-arterial; infusion technique, each additional hour (list separately in addition to code for primary procedure) 

Change: CPT 2007 removes the phrase -up to 8 hours- from code 96423.

Remember: You won't have a grace period for the new codes. You need to use the codes for services provided on or after Jan. 1.