Oncology & Hematology Coding Alert

Question: Our patient required a breast board for radiation treatment. We took a standard device, customized it, and used it for this patient.
Is this still considered a simple treatment device?


Connecticut Subscriber


Answer: Because you customized the breast board, you should report 77333 (Treatment devices, design and construction; intermediate [multiple blocks, stents, bite blocks, special bolus]) instead of the code for the simple device, 77332 (Treatment devices, design and construction; simple [simple block, simple bolus]). If you see no proof of customization, report 77332.

Caution: Before you report 77333, be sure your oncologist documented his involvement in the design, selection, and placement of the devices.

You should also use 77333 for other customized and reused devices, which may include pituitary boards, testicular shields, and stereotactic head frames.

Other devices that merit 77333 include stents, oral devices, and special bolus, such as full slab, custom-cut slab, and batter-mixed. Remember: Payers usually won't cover bolus unless it is the only treatment device for a particular radiation port.

Watch for: Typically, Medicare and private payers allow you to report 77333 if you have documentation of three or more standard field blocks, but, as always, check your local policy. Some payers maintain that pre-made beam splitter blocks and pre-made midline spinal cord blocks are simple devices.