Wiki IMRT Documentation

[Revenuecycle]

Does anyone have guidelines they follow when billing IMRT's ? We are being hit by RAC stating documentation is not supporting medical necessity. Any information or suggestions for documentation requirements would greatly be appreciated. I am in NY.

Thanks.

 

[rocoder]

IMRT docs

For not medically necessay denials we submit appeal letters with IMRT vs. 3D comparison information. The doc that we include are the consult note, IMRT plan, DVH graph for IMRT, DVH graph for the 3D plan (that was performed for the comparison) and any radiology reports available. I also include peer reviewed studies to support the use of IMRT. Hope this helps!