Wiki Global Period for 77427?

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briansmith99

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This code is used in Radiation Oncology for E/M services provided during ongoing radiation treatments. CMS instructions on the use of the code are clear for how frequently it can be used (billable 1 time for every 5 fractions of radiation treatment). I've also heard (most recently in AAPC's webinar May 2024) that there is a global period of 90 days which is maybe attached to the 77427. I cannot find documentation to support this rule and wondered if there is anyone out there who has seen this in an LCD or somewhere else?

CMS lists their billing and coding guidelines here (this LCD does not document this rule) -

 
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briansmith99 said:
This code is used in Radiation Oncology for E/M services provided during ongoing radiation treatments. CMS instructions on the use of the code are clear for how frequently it can be used (billable 1 time for every 5 fractions of radiation treatment). I've also heard (most recently in AAPC's webinar May 2024) that there is a global period of 90 days which is maybe attached to the 77427. I cannot find documentation to support this rule and wondered if there is anyone out there who has seen this in an LCD or somewhere else?

CMS lists their billing and coding guidelines here (this LCD does not document this rule) -

Click to expand...

77427 has a global period of 90 days of completion of the course of radiation treatment. You can find that documented in the ASTRO Radiation Oncology Coding Resource:


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It can also be found in the Medicare Claims Processing Manual, Chapter 13. Here's a link to that: https://www.cms.gov/regulations-and-guidance/guidance/manuals/downloads/clm104c13.pdf

The applicable sections are 70.1 - Weekly Radiation Therapy Management and 70.2 - Services Bundled Into Treatment Management Codes. (Approximately pages 44-47 at the link)

Section 70.2 gives a detailed list of the services bundled into the treatment management and is worth a look.

Hope this helps!
 
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