Oncology & Hematology Coding Alert
Bite the Bullet--Report Only Highest Level Block
Illinois Subscriber
Answer: Code 77333 (Treatment devices, design and construction; intermediate [multiple blocks, stents, bite blocks, special bolus]) does have a professional component, which you may claim by appending modifier 26 (Professional component).
Hidden trap: Most payers only cover one beam-shaping device per port and one immobilization device per therapy course. You should report the highest documented level device.
Example: The patient requires a mask that merits 77334 (... complex [irregular blocks, special shields, compensators, wedges, molds, or casts]) as well as a bite block. You should only report 77334-26.
Remember: The professional component requires the physician to participate in the actual design of the device. Treatment devices are customized blocks or shields intended to protect healthy tissue surrounding the treatment area. They-re made from special energy-absorbing materials. Immobilization devices help the patient maintain one position that he can reproduce throughout the therapy course.
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