Oncology & Hematology Coding Alert

Question: Some of our patients receive only two fractions per week, but have an increased dose per fraction--which means extra work for the physician. Is there a way to reflect this in the radiation treatment management code?


California Subscriber

Answer: Probably not, because you report the management based on the number of treatments (fractions), not the actual time frame.

Example: The patient receives five treatments over three weeks. You should report the treatment management once with 77427 (Radiation treatment management, five treatments). Because the descriptor specifies five treatments, you may only report the code once for each five fractions the physician provides.

Remember: Treatment management includes examination of the patient for medical evaluation and management, including assessing the patient's response to the treatment, coordinating care, and reviewing imaging and lab results. You also include review of the following: port films, dosimetry, dose delivery, treatment parameters, and patient treatment set-up.