Money in the Bank:
Earn More Than $900 per Brachytherapy Procedure
Published on Tue Aug 26, 2008
Keep these HDR descriptors straight to guarantee solid claims every time Keeping track of all of the terminology used in brachytherapy isn't easy. You may feel a little befuddled by what "remote afterloading" refers to when coding high dose rate (HDR), or you may not be entirely sure what "high-intensity" means. Not to worry, though. Just let our experts share their insights with you on how to identify all the necessary components of 77781-77784, and how you can apply them correctly every time based on the information you find in your documentation. Here Are the First 4 Things You Need to Know The are four CPT codes that specifically describe remote afterloading high-intensity brachytherapy: - 77781 -- Remote afterloading high-intensity brachytherapy; 1-4 source positions or catheters - 77782 -- ... 5-8 source positions or catheters - 77783 -- ... 9-12 source positions or catheters - 77784 -- ... over 12 source positions or catheters. Heads up: CPT includes a note with 77781-77784 indicating that you shouldn't report these codes with 0182T (High dose rate electronic brachytherapy, per fraction), which you should use to report "provision of brachytherapy with electronically generated photons," according to the AMA's CPT Changes 2008. Be Sure You Understand Each Code Element Here's what our experts have to say regarding each component of the 77781-77784 descriptors. You can use these explanations to describe the services your physician should document for you to report these codes. "Remote afterloading": For HDR brachytherapy, a single high-intensity radioactive material is supplied through one or more catheters by a special machine, says Cindy Parman, CPC, CPC-H, RCC, co-owner of Coding Strategies Inc. in Powder Springs, Ga. In-depth explanation: Remote afterloading refers to the machine applying radioactive material after inserting the catheters. "High-intensity brachytherapy": Brachytherapy involves the placement of encapsulated radioactive material, often cesium, iridium or cobalt, in or near tumor tissue. HDR material delivers radiation at a rate of 10 cGy to 100 cGy per minute, Parman says. Low dose (LDR) delivers the same dose per hour. More info: HDR requires less patient treatment time and can be performed as an outpatient service, making it increasingly more popular with patients than LDR, according to Parman. Note: HDR treatments involve radiation sources that are used again and again for multiple patients. Payers include the cost of this sort of source in the HDR treatment codes, meaning that even if your freestanding center supplies the material, you shouldn't charge separately for it, according to the Nov. 1, 2002, Federal Register. Note: Hospitals may report C1717 (Brachytherapy source, nonstranded, high dose rate iridium-192, per source) under Outpatient PPS. "Source positions or catheters": The final element of codes 77781-77784 is based on the number of source positions -- also known as [...]
