tci Outpatient Facility Coding Alert - 2016 Issue 9

Radiation Therapy: OIG to Weigh In On Intensity-Modulated Radiation Therapy Payments

Know what is covered by IMRT planning code 77301. The OIG has decided to review Medicare outpatient payments for intensity-modulated radiation therapy (IMRT), to analyze whether CMS paid for these services according to the Federal guidelines. Could there be any specific reason behind OIG choosing this particular therapy for post-payment audits now? Read on to find out. Background: IMRT is an advanced process that uses computer-driven technology to impart accurate radiation doses to precise areas within a tumor, malignant or otherwise. Prior OIG reviews have identified hospitals that have incorrectly billed for IMRT services. Furthermore, the service is provided...

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