Wiki CPT 77290,77318,77370

[JayalakshmiF]

Hello,

The CPT 77290,77318,77370 getting denied as it is approved for 1 Unit and got paid already a week before for the same service CPT's. so we submitted Appeal with MR. But Received appeal denial letter from Cigna as appeal upheld as more units billed than were allowed . Please advice the frequency limit of the billed service CPT's.

 

[sls314]

Hello,

The CPT 77290,77318,77370 getting denied as it is approved for 1 Unit and got paid already a week before for the same service CPT's. so we submitted Appeal with MR. But Received appeal denial letter from Cigna as appeal upheld as more units billed than were allowed . Please advice the frequency limit of the billed service CPT's.

Why are you billing those charges again a week later?

77370 (Special medical radiation physics consultation) can only be billed once per episode of care. If you've billed it once already, you can't bill it again for that course of treatment.

77318 (Brachytherapy isodose plan, complex) - An isodose plan is typically performed once for each brachytherapy applicator insertion procedure. If multiple insertions are performed, there may be multiple isodose plans. Was there another insertion? Is there a record of another isodose plan for your DOS? If there wasn't another isodose plan documented, you shouldn't bill for another one

77290 (simulation) - Was a new simulation performed and documented?