Oncology & Hematology Coding Alert

Reader Questions:

Pause Before Coding Stopped Procedure

Question: We recently had a situation in which the oncologist decided not to perform radioelement application after the HDR catheters were implanted in the patient. Which CPT codes should we report when this happens?

North Dakota Subscriber


Answer:
Your best bet may be an unlisted surgical code based on where the catheters were inserted in the body.

Key: You should not report an interstitial (77776-77778) or HDR (77781-77784) code for this encounter.

Note: If the oncologist was inserting the radioelement and then discontinued the procedure because the patient's well-being was at risk, you can report 77761 (Intracavitary radiation source application; simple) with modifier 53 (Discontinued procedure). You should add a diagnosis code from the V64 series (such as V64.1, Surgical or other procedure not carried out because of contraindication) to support the incomplete service.

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