Oncology & Hematology Coding Alert
Simple vs. Complex for Radiation Therapy Planning
Question: How do we report the planning of radiation therapy for skeletal metastasis? New Mexico Subscriber Answer: You should check the clinical note to confirm what radiation therapy was planned, how many ports it involved, use of blocks, time taken for radiation treatment, assessment of tumor volume, and more. Given the limited information, you can assume skeletal metastasis was localized and your physician did a simple radiation treatment planning. Submit code 77261 (Therapeutic radiology treatment planning; simple) for simple radiation treatment planning. Diagnosis code: Also, submit one of the following ICD-10-CM codes C79.51 (Secondary malignant neoplasm of bone) or C79.52 (Secondary malignant neoplasm of bone marrow) for the skeletal metastasis. More than one treatment areas: Report code 77262 (Therapeutic radiology treatment planning; intermediate) when your oncologist plans to treat 2 separate non-contiguous treatment areas and code 77263 (Therapeutic radiology treatment planning; complex) for 3 or more separate treatment areas. Also, look for ports and blocks used, use for special lab tests or other radiological assessments like CT/MRI localization, and any use of protection for the critical or sensitive organs.
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