tci Part B Insider - 2006 Issue 10

RADIOLOGY: Don't Let Multiple Radiation Treatments Trip You Up

Experts warn:  Make sure documentation proves medical necessityCertain types of cancer require two or more radiation treatments a day. Here's the lowdown on how to tell when--and how--you can report multiple treatments.You may report codes 77401-77416 more than once per date of service only when the patient receives radiation treatment "during completely different sessions," says CMS program memorandum A-03-020 at www.cms.hhs.gov/transmittals/downloads/A03020.PDF. The problem: CMS doesn't define "completely different sessions." Best bet: Payors usually want a six-hour break between twice-daily radiation treatments, explains Pamela Moore, CPC, patient representative at Moll Cancer Center in...

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