Radiology Coding Alert

The Correct Coding Initiative (CCI), version 14.1, answered your call for an end to radiosurgery edits that had coders up in arms. Here's how to take advantage of this good news.

Effective April 1, CCI deleted the edits bundling 77300 (Basic radiation dosimetry calculation, central axis depth dose calculation, TDF, NSD, gap calculation, off axis factor, tissue inhomogeneity factors, calculation of non-ionizing radiation surface and depth dose, as required during course of treatment, only when prescribed by the treating physician) and 77334 (Treatment devices, design and construction; complex [irregular blocks, special shields, compensators, wedges, molds or casts]) with these radiosurgery treatment delivery codes:

• 77371 -- Radiation treatment delivery, stereotactic radiosurgery (SRS), complete course of treatment of cranial lesion(s) consisting of 1 session; multi-source Cobalt 60 based

• 77372 -- ... linear accelerator based

• 77373 -- Stereotactic body radiation therapy, treatment delivery, per fraction to 1 or more lesions, including image guidance, entire course not to exceed 5 fractions.

CCI deleting the 77300 and 77334 edits with radiosurgery (77371-77373) is great news, says Cindy Parman, CPC, CPC-H, RCC, co-owner of Coding Strategies Inc. in Powder Springs, Ga.

Old way: "Prior to this change, the basic calculations were listed with a modifier indicator of '1,' " Parman says.

General rule: Modifier indicator "1" means that you can override the edit with modifier 59 (Distinct procedural service) in appropriate circumstances, says Vicky Varley O'Neil, CPC, CCS-P, owner of The Hazlett Group in St. Louis, Mo., in The Coding Institute audio-conference "Modifiers 25 and 59 Best Practices That Keep Your Claims in the Clear" (http://www.audioeducator.com).

How to apply it: For these particular edits, you could report the codes "separately with a modifier only when the calculations were performed for a separate anatomic site than the tumor volume receiving radiosurgery," Parman says.

New way: This change in the bundling edits allows you to report the dosimetry calculations in addition to the radiosurgery plan and treatment devices "at a frequency of one unit per gantry angle, shot, path or arc depending on the type of equipment used for treatment," Parman says.

Resource: You can download more information on the CCI 14.1 edits when you visit the CMS Web site at http://www.cms.hhs.gov/NationalCorrectCodInitEd/.