Oncology & Hematology Coding Alert

Question: If the oncologist treats multiple fields using IMRT in a single session, should I report more than one unit of 77418? Colorado Subscriber Answer: No. You should report 77418 (Intensity modulated treatment delivery, single or multiple fields/arcs, via narrow spatially and temporally modulated beams, binary, dynamic MLC, per treatment session) once per session. The code definition specifies that the code applies to "single or multiple fields/arcs ... per session." CPT Assistant (March 2010) addresses a similar question in its Coding Consultation section and explains that reporting 77418 more than once per session would be inappropriate. Smart move: Take extra care to be sure you're reporting 77418 properly. A Florida physician group recently agreed (without admitting wrong-doing) to pay the government $12 million to settle a case involving fraud allegations, including the use of IMRT in cases when the government maintains lower-priced standard radiation treatment would have worked just as [...]