Oncology & Hematology Coding Alert

READER QUESTIONS:

Bite the Bullet--Report Only Highest Level Block

Question: May I report the professional component of 77333 for a bite 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.
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in Revenue Cycle Insider
  • 6 annual AAPC-approved CEUs
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more

Other Articles in this issue of

Oncology & Hematology Coding Alert

View All