Oncology & Hematology Coding Alert

Question: What services does 77427 include?

North Dakota Subscriber

Answer: You should apply 77427 (Radiation treatment management, five treatments) to patient supervision and care during radiation therapy. That means that the majority of your radiation oncologist's services during this period fall under 77427.

Do: Include review of the following in one unit of 77427, per CPT guidelines:

• port films
• dosimetry
• dose delivery
• treatment parameters
• patient treatment setup.

You should also include patient assessment in the radiation treatment management code, along with any changes to the plan.

Don-t: You shouldn't report 77427 automatically each calendar week even though providers often refer to these services as -weekly treatment management.-

The descriptor for 77427 specifically refers to -five treatments.- Report the code once for every five treatments rather than reporting it once per calendar week of treatment.

Do: You should code three to four leftover fractions (radiation therapy treatment units) as an additional 77427 unit if you have documentation of a patient evaluation during these final treatment fractions.

Don-t: You should not report 77427 or 77431 (Radiation therapy management with complete course of therapy consisting of one or two fractions only) for one or two leftover fractions.