Oncology & Hematology Coding Alert

Question: Should we bill 77336 each time our physicist checks the patient record? What about when there are multiple chart reviews in the same week?

Pennsylvania Subscriber
 
Answer: The description of 77336 (continuing medical physics consultation, including assessment of treatment parameters, quality assurance of dose delivery, and review of patient treatment documentation in support of the radiation oncologist, reported per week of therapy) is very specific. Although some payers have unique guidelines regarding the date of service for this code, payers generally request that this service be billed per week of therapy in the same manner as the physician treatment management service is billed using 77427 (radiation treatment management, five treatments).  
 
Therefore, 77336 is billed on the fifth fraction, 10th fraction, 15th fraction, etc., and represents the physicist work during that five-fraction segment of patient therapy. A fraction is a single session of radiation treatment. While we tend to think of this code as payment for the chart review, continuing physics includes a number of patient-specific services. Documentation of these services is often reflected in the chart check form completed in the patient record, but this service includes ongoing discussions with the radiation oncologist regarding changes in the prescription, addition or discontinuation of wedges, changes in field sizes, and a review of dose amount delivered through each field.