You Be the Coder:
Two Codes, One Day
Published on Fri Mar 01, 2002
Test your coding knowledge. Determine how you would code this situation before looking at the box below for the answer.
Question: Can we bill 77295 and 76370 on the same day and get paid for both?
California Subscriber
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Answer: Code 77295 (Therapeutic radiology simulation-aided field setting; three dimensional) involves 3-D, computer-generated reconstruction of tumor volume and surrounding critical normal tissue structures from direct CT scan and/or MRI data in preparation for non-coplanar or coplanar therapy. The simulation uses documented 3-D beam's eye-view volume-dose displays of multiple or moving beams.
Code 76370 (Computerized axial tomographic guidance for placement of radiation therapy fields) involves obtaining CT slices for use in the treatment planning software to localize the radiation treatment portals. However, when 76370 is billed on the same day as 77295, a Medicare Correct Coding Initiative (CCI) bundling edit combines these two codes with an indicator of "0," which means modifier -59 (Distinct procedural service) will not bypass the edit and payment will be denied. This bundling edit indicates that obtaining the CT slices is an integral part of the
3-D planning process and is not a significant, separate procedure. | |
