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Oncology & Hematology Coding Alert

READER QUESTIONS:

Choose 77427 -- Not E/M -- for Weekly Check

Published on Thu May 28, 2009

Question: Ive just started coding radiation oncology and heard the oncologist can bill an E/M for the patients weekly assessment in addition to daily treatments. Is there any guidance supporting this? Illinois Subscriber Answer: You should not report an E/M for the weekly assessment. But you may report 77427 (Radiation treatment management, 5 treatments) for the physicians service. AMAs CPT Assistant (Feb. 2000) states that 77427 covers everything from the simple cases (weekly exam and prescription writing) to complex cases (daily exams, managing side effects from nausea to infection to radiation-induced cystitis and beyond, as well as reviewing labs and imaging, and coordinating with other health professionals and support services, and more). CPT Assistant also states you should not report E/M separately when reporting 77427 because radiation treatment management guidelines explain that 77427 includes medical evaluation and management. Remember: When you have documentation of a visit, you should report 77427 [...]
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