Oncology & Hematology Coding Alert

Question: I am trying to code for treatment devices. The oncologist used a bolus specially made for the patient during the treatment and I’m not sure if that constitutes a simple, intermediate, or complex device. Should I use the code 77332, 77333, or 77334?

Ohio Subscriber

Answer: You must use the code 77334 (Treatment devices, design and construction; complex [irregular blocks, special shields, compensators, wedges, molds or casts]).

The trick to identifying the right code to use is to understand the definitions of simple, intermediate, and complex devices. The definition of code 77334 mentions the treatment device must be labeled complex while code 77332 (Treatment devices, design and construction; simple [simple block, simple bolus]) and code 77333 (Treatment devices, design and construction; intermediate [multiple blocks, stents, bite blocks, special bolus]) identify simple and intermediate respectively.

So what do these three terms mean? Each term describes varying levels of complexity for devices used during an oncology treatment. Simple usually refers to devices which can be used on a number of patients including devices like non-custom boluses, vaginal cylinders, breast boards, and prostate templates. Intermediate refers to devices like bite blocks and testicular shields. Complex indicates the device used was particular to an individual patient like a face mask, a multi lead collimator, or a custom-made bolus.

In your case, the bolus was made for a particular patient. This means that, unless modified, the bolus device cannot be used universally. The definition of code 77334, states custom boluses are included, and therefore, would be the code you want to use.