Radiology Coding Alert

Act on this NCCI edit deletion today

Good news, stereotactic radiation coders: Here's your chance to appeal denials retroactive to Jan. 1, 2007.
 
National Correct Coding Initiative version 13.1 deletes edits bundling stereotactic treatment management codes with stereotactic treatment codes, according to the American College of Radiation Oncology (www.acro.org/content/srs_coding.cfm).
 
With the deletion of these edits, you'll be able to bill the following:
 
• 77432 (Stereotactic radiation treatment management of cerebral lesion[s] [complete course of treatment consisting of one session]) on the same date as 77371-77372 (Radiation treatment delivery, stereotactic radiosurgery [SRS], complete course of treatment of cerebral lesion[s] consisting of 1 session ...)
 
• 77435 (Stereotactic body radiation therapy, treatment management, per treatment course, to one or more lesions, including image guidance, entire course not to exceed 5 fractions) on the same date as 77373 (Stereotactic body radiation therapy, treatment delivery, per fraction to 1 or more lesions, including image guidance, entire course not to exceed 5 fractions).

This edit doesn't affect hospitals, because they don't bill professional services, but it's been a problem for freestanding centers.

Here's the Reason

You normally conduct stereotactic radiosurgery in a single-fraction scenario, so you would typically bill physician management in the same session as the treatment, says Deborah Churchill, RTT, president of Churchill Consulting in Killingworth, Conn. So that set of NCCI edits was an error, she says.
 
Action plan: Because NCCI will delete these edits retroactively, you can resubmit any claims denied since January. Remember: CMS won't automatically reprocess any denials.
 
Benefit: CMS pays about $600 for 77435 and $400 for 77432.