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2018 CPC Practice Exam Answer Key 150 Questions With Full Rationale (HCPCS, ICD-9-CM, ICD-10, CPT Codes) Click here for more sample CPC practice exam questions with Full Rationale Answers

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Click here for more sample CPC practice exam questions and answers with full rationale

Radiation Therapy issue

We do radiation therapy for non-melanoma skin cancer- we were previously billing 77401 however it has since been mentioned that G6003 should be utilized. Being that this is "SRT" we had been using 77401- code G6003 is for UP to 5 MeVs which we do not exceed (we are below 1) can this code be used? We also do IGRT that we are having an issue getting approved from authorization carriers.
Any insight from someone who has experience in this field would be great. Thank you!

Medical Billing and Coding Forum

Radiation Oncology

I have a Radiation physician who is wanting to bill for education (E/M codes 99213-99214) once simulation has been performed. I know that hospitals should not report a patient visit during the course of radiation therapy but is simulation considered the start of therapy or can an E/M educational service be billed post simulation?
I appreciate any guidance you can provide on this one.

Medical Billing and Coding Forum

Radiation Proctitis vs. Soft Tissue Radionecrosis

I have a physician that is ordering Hyperbaric Oxygen Therapy for a patient with documented radiation proctitis. He is arguing that radiation proctitis is the same thing as soft tissue radionecrosis, and he is wanting to bill with L59.8 (specified disorder of skin and subcutaneous tissues related to radiation) instead of K62.7 (radiation proctitis). I understand that L59.8 is payable for HBOT, but I’m having trouble finding anything to support whether or not this is an accurate diagnosis for what is actually happening with the patient. We are under the NGS MAC. Can anyone offer any resources or advice? Thank you.

Medical Billing and Coding Forum

Radiation Oncology coding and billing

Hello! I am new to radiation oncology coding and billing. Does anyone have any resources, cheat sheets or tips they would be willing to share with me? Anything would be greatly appreciated! I am tasked with coding radiation therapy, charge entry and working back end denials that have been sitting for awhile.

Also, my employer is looking to send me to a workshop or seminar. Does anyone know of any on the east coast after October 1st?

Medical Billing and Coding Forum

2015 new CPT Codes for RADIATION THERAPY


Radiation therapy codes underwent significant changes for 2015. Teletherapy isodose planning and brachytherapy codes now include the basic dosimetry calculation and IMRT codes now include guidance and tracking. Also radiation treatment delivery codes were deleted in 2015.

77306  Teletherapy isodose plan; simple (1 or 2 unmodified ports directed to a single area of interest), includes basic dosimetry calculation(s)

77307  Teletherapy isodose plan; complex (multiple treatment areas, tangential ports, the use of wedges, blocking, rotational beam, or special beam considerations), includes basic dosimetry calculation(s)

77316  Brachytherapy isodose plan; simple (calculation[s] made from 1 to 4 sources, or remote afterloading brachytherapy, 1 channel), includes basic dosimetry calculation(s)

77317  Brachytherapy isodose plan; intermediate (calculation[s] made from 5 to 10 sources, or remote afterloading brachytherapy, 2-12 channels), includes basic dosimetry calculation(s)

77318  Brachytherapy isodose plan; complex (calculation[s] made from over 10 sources, or remote afterloading brachytherapy, over 12 channels), includes basic dosimetry calculation(s)

77385  Intensity modulated radiation treatment delivery (IMRT), includes guidance and tracking, when performed; simple

77386  Intensity modulated radiation treatment delivery (IMRT), includes guidance and tracking, when performed; complex

77387  Guidance for localization of target volume for delivery of radiation treatment delivery, includes intrafraction tracking, when performed

See also complete list of 2015 CPT Changes


Coding Ahead

Radiation Oncology

I bill out for the PC side of Radiation Oncology in an out pt hosp setting. I am having trouble suddenly on getting some claims paid for 77427 and also 77014. I was thrown into this without any training and am getting very confused on modifiers and such. All I read is about the TC side. My doctor loves to do all kinds of codes together and I’m just lost. Is there any help out there?

Karen l

Medical Billing and Coding Forum

Any Radiation Oncology Experts?

We are running into a bit of an issue when coding 77300, 77301 and 77307.

The following edits appear:

Column 1 / Column 2
77301 / 77307

Column 1 / Column 2
77307 / 77300

Since 77301 does not allow 77307, once I remove 77307 am I ok to bill 77300?
Or because they all exist together on the original bill, should I remove both 77307 and 77300?

Thanks so much!

Medical Billing & Coding Forum | AAPC

Radiation Oncology

I just started coding Radiaiton Oncology and need some guidance on coding 77412 for medicare patients. Can 77412 be charged to medicare patients or do I substitute with another code? I’ve read so much information from so many websites that I think I’m more confused now then when I started.

Thanks for helping!!!:confused:

Medical Billing and Coding

PLEASE HELP! Radiation soft tissue injury of the brain ICD-10 code(s)

I am having trouble determining the correct ICD-10 diagnosis code(s) for "Radiation soft tissue injury of the brain". One of my providers is treating a patient for this condition with hyperbaric oxygen therapy. He also refers to the condition as "Radiation therapy induced brain necrosis". I have done a lot of research and the choices seem to come down to L59.8- Other specified disorders of the skin and subcutaneous tissue related to radiation and a combination of I67.89- Other cerebrovascular disease and Y84.2-Radiological procedure and radiotherapy as the cause of abnormal reaction of the patient, or of later complication, without mention of misadventure at the time of the procedure. I do know that brain radionecrosis is considered a covered dx for hyperbaric treatment by some payers, but I67.89 and Y84.2 do not seem to be covered on the NCD. On the other hand, L59.8 is covered by the NCD, but I am not sure that diagnosis pertains to the brain. There is also T66.XXXA- Radiation sickness, unspecified, initial encounter, but that doesn’t seem specific enough and is also not covered by the NCD. I have been going in circles with this for a while now. Any and all help is VERY much appreciated. Thank you!!!

Angie Knight, CPC

Medical Billing and Coding