Oncology & Hematology Coding Alert

Question: Can I report 77331 for calibration of electron cutouts? What are the other conditions that allow me to report special dosimetry?

Utah Subscriber

Answer: No, you can't report 77331 (Special dosimetry [e.g., TLD, microdosimetry] [specify], only when prescribed by the treating physician) for electron cutout calibration, unless your individual payer tells you to. The name "special dosimetry" tells you to report this service only under very special circumstances.
 
Do: Report special dosimetry when the oncologist documents that he ordered special radiation measuring and monitoring devices to determine the correct radiation dosage at a given point and then use the results to accept or modify the treatment plan. Most patients don't require this service, so the physician should include an explanation of medical necessity.
 
The monitoring devices may include thermoluminescent dosimeters (TLD), solid-state diode probes, special dosimetry probes, or film dosimetry. Your doctor must document the type of special dosimetry.
 
Don't: You should never use 77331 for routine quality-assurance monitoring. This means you should not report this code for room surveys, patient surveys, or routine plan verification.
 
Do: Watch for careful documentation before you report 77331. You must have a written order from the treating physician. The documentation should describe the special radiation measuring and monitoring devices and all of the treatment fields that required special dosimetry. Both the doctor and physicist should sign a hard copy of the measurements, and you should have documentation prior to the measurement explaining how the special dosimetry will affect the patient's current treatment plan.
 
Remember: Payers typically reimburse 77331 once per port per course of treatment when you meet the conditions for medical necessity. In the rare case that your documentation supports the need for an additional service, you may code 77331 again.