Oncology & Hematology Coding Alert

Question: In a patient with advanced resistant prostate cancer, our oncologist administered radium Ra 223 (Xofigo). How can we report for this service? How do we code for the planned injections of Xofigo?

North Carolina Subscriber

Answer: Radium Ra 223 (Xofigo) is administered as a regimen of 6 injections. Your physician may plan for a total of 6 injections to be administered at 4-week intervals. According to the medication package insert, the dose of radium Ra 223 is 55 kBq (1.49 microcurie) per kg body weight.

Two options: You have two options to report the administration of the radiopharmaceutical Xofigo:

• 79101 (Radiopharmaceutical therapy, by intravenous administration)
• 77750 (Infusion or instillation of radioelement solution (includes 3-month follow-up care))

How to choose: When your provider is certain about seeing the patient for follow-up care, you submit code 77750. However, when your provider does not anticipate seeing the patient again as part of regular follow-up, you submit code 79101. The code 79101 applies to any unplanned follow-up care your physician provides in the 90-day global period.

Keep in mind: Modifier 26 (Professional Component) will need to be appended to the CPT^® code if you are reporting only the professional component for the radiology service. Same with modifier TC (Technical component) if you are reporting only the technical component. Do not append a professional or technical modifier to the radiology code when reporting a global service in which one provider renders both the professional and technical components.

Remember: The codes listed above represent the administration. The entity which bears the cost of the radiopharmaceutical may report the radiopharmaceutical substance separately using the appropriate code. For the supply of Xofigo, turn to code A9606 (Radium Ra-223 dichloride, therapeutic, per microcurie).