Oncology & Hematology Coding Alert

Question: Which codes should I report for gamma knife treatment? I bill for an oncologist in an outpatient hospital.

Kansas Subscriber

Answer: For the radiation oncologist's role in gamma knife radiosurgery, you should report 77432 (Stereotactic radiation treatment management of cranial lesion[s] [complete course of treatment consisting of one session]).

Typically, the radiation oncologist works with a neurosurgeon for gamma knife radiosurgery. A note with 77432 specifies that the surgeon should report the radiosurgery with 61793 (Stereotactic radiosurgery [particle beam, gamma ray or linear accelerator], one or more sessions).

Depending on the oncologist's documentation over the course of working with the patient, you may also report:

- 77263 -- Therapeutic radiology treatment planning; complex

- 77295-26 -- Therapeutic radiology simulation-aided field setting; 3-dimensional-Professional component

- 77300-26 -- Basic radiation dosimetry calculation, central axis depth dose calculation, TDF, NSD, gap calculation, off axis factor, tissue inhomogeneity factors, calculation of non-ionizing radiation surface and depth dose, as required during course of treatment, only when prescribed by the treating physician

- 77334-26 -- Treatment devices, design and construction; complex (irregular blocks, special shields, compensators, wedges, molds or casts).

Note that only certain codes (77295, 77300, 77334) require modifier 26. The Medicare physician fee schedule does not split the other codes (77432, 77263) into professional and technical components.