Radiology Coding Alert

READER QUESTIONS:

Rarely Repeat 77295 Claim

Question: Is it ever OK to code more than one 3D simulation during the same course of radiation treatment?


Connecticut Subscriber


Answer: With the proper documentation, you may report 77295 (Therapeutic radiology simulation-aided field setting; 3-dimensional) more than once.

Example 1: The physician orders two separate 3D plans, each requiring a separate data set of CT slices because the patient has more than one primary cancer or multiple body areas that need 3D planning.

Example 2: The physician orders a second 3D plan for a patient who receives therapy based on a 3D plan and then his tumor size changes. Because of the change, he requires a new data set to develop a boost plan. This circumstance is fairly rare, so only report a second plan when you're sure the patient record backs up your choice.

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