Oncology & Hematology Coding Alert

Question: We treated a patient with conventional radiation therapy (77414) and then used an IMRT boost. How can we bill the therapy, IMRT planning (77301) and physics consult?

Tennessee Subscriber Answer: Report 77414 (Radiation treatment delivery, three or more separate treatment areas, custom blocking, tangential ports, wedges, rotational beam, compensators, special particle beam [e.g., electron or neutrons]; 11-19 MeV) as you would without the IMRT (intensity modulated radiation treatment).

For the IMRT boost, you should use 77301 (Intensity modulated radiotherapy plan, including dose-volume histograms for target and critical structure partial tolerance specifications), and for the daily radiation treatment, assign 77418 (Intensity modulated treatment delivery, single or multiple fields/arcs, via narrow spatially and temporally modulated beams [e.g., binary, dynamic MLC], per treatment session).

Code 77370 (Special medical radiation physics consultation) represents the physics consult. But you cannot report 77370 on the same day as 77301, because the National Correct Coding Initiative bundles the codes.