Oncology & Hematology Coding Alert

Reader Question:

Work, Not Circumstance, Supports 77470

Question:

Does presence of a cardiac device (like a pacemaker) qualify as a reason to code 77470?

Indiana Subscriber

Answer:

Whether you may report 77470 (Special treatment procedure [e.g., total body irradiation, hemibody radiation, per oral, endocavitary or intraoperative cone irradiation]) depends on the additional work required for a particular circumstance rather than on the mere existence of that circumstance.

In other words: If your documentation clearly demonstrates that the presence of a device, such as a pacemaker, required the oncologist to put in extra time, effort, and resources for this patient, you may consider reporting 77470. The device's presence alone isn't enough to support reporting 77470.

Also, remember that you should report 77470 only once per course of therapy. CPT's note under the code specifies that "77470 assumes that the procedure is performed 1 or more times during the course of therapy, in addition to daily or weekly patient management."

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