SIVAD63
Contributor
We have noticed a lot more denials since the LCD's for IMRT, SRS. SBRT. One particular area that is requiring more appeals is our 3D planning 77295. Although they do not have an LCD for 3D , the 3D is listed under the SRS and SBRT.
The carriers are denying the 3D 77295 even for our EBRT. This is so frustrating and time consuming. Our planning codes , cals and MLC devices are submitted first before the treatment delivery has started, the carriers automatically denies these due to the 3D planning is listed for SRS and SBRT. Its not until the Treatment delivery code are submitted 774xx or G60xx., are submitted for them to overturn the decision. This is adding days on our Revenue Cycle.
Are any other site for radiation seeing these denials ? If so, has any one found a way to identify these claims prior to submission that we are NOT using the 3D plan for treatment delivery of the following codes 77373, 77372, 77371 SRS and SBRT.
The carriers are denying the 3D 77295 even for our EBRT. This is so frustrating and time consuming. Our planning codes , cals and MLC devices are submitted first before the treatment delivery has started, the carriers automatically denies these due to the 3D planning is listed for SRS and SBRT. Its not until the Treatment delivery code are submitted 774xx or G60xx., are submitted for them to overturn the decision. This is adding days on our Revenue Cycle.
Are any other site for radiation seeing these denials ? If so, has any one found a way to identify these claims prior to submission that we are NOT using the 3D plan for treatment delivery of the following codes 77373, 77372, 77371 SRS and SBRT.