Oncology & Hematology Coding Alert

Take Action Against These Common 77301 Claim Killers

Applying these NCCI edits is a must for clean IMRT plan claims

Col. 1  

- IMRT Tx plan: 77301

Col. 2

- CT:
70450-70492, 71250-71270, 72125-72133, 72192-72194, 73200-73202, 73700-73702, 74150-74170, 76380

- CT angiography: 70496-70498, 71275, 72191, 73206, 73706, 74175, 75635

- 3D rendering: 76376, 76377

- CT/US guidance for placement of radiation therapy fields: 76950, CPT 77014

- Therapeutic radiology treatment planning: 77261-77263

- Therapeutic radiology simulation-aided field setting: 77280-77295 

- Teletherapy plan: 77305-77321

- Brachytherapy plan: 77326-77328

- Special dosimetry: 77331

- Treatment devices: 77332-77334

- Physics consultation: 77336-77370

- Radiation treatment delivery: 77401-77417, 77421-77423, 77520-77525 

- Radiation management: 77431-77470

- Office or other outpatient E/M: 99201-99215

- Hospital E/M: 99217-99239

- Critical/intensive care: 99289-99300

- Nursing/other boarding facility care: 99304-99337

You-ll find IMRT treatment planning as a column 1 code in hundreds of National Correct Coding Initiative column 1/column 2 edits. This handy chart will let you see the most important ones at a glance. For the full list of edits, go to the CMS Web site www.cms.hhs.gov/NationalCorrectCodInitEd/NCCIEP/list.asp#TopOfPage.

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