Oncology & Hematology Coding Alert

Think you know all you need to know about planning for complex radiation treatment therapy (77263, Therapeutic radiology treatment planning; complex)? Think again. Complex planning includes a number of other attributes, which you should find in your physician's documentation.
 
Clip and save this checklist provided by Cindy Parman, CPC, CPC-H, RCC, principal and co-founder of Coding Strategies in Powder Springs, Ga.

 1. A physician has diagnosed a patient with early or advanced disease that's complex in distribution, such as a head tumor (195.0).

 2. Your radiation oncologist will most likely perform stereotactic radiosurgery (G0242, Multi-source photon stereotactic radiosurgery [cobalt 60 multi-source converging beams] plan, including dose volume histograms for target and critical structure tolerances, plan optimization performed for highly conformal distributions, plan positional accuracy and dose verification, all lesions treated, per course of treatment).

 3. Treatment calls for complex blocking methods like TBI hemibody, AP/PA mantle, inverted Y and partial transmission.

 4. Your physician combines modalities, such as hyperthermia, chemotherapy, brachytherapy, surgery, electrons and photons.

 5. Patient faces risk of long-term complications, thermal injury or skin graft.

 6. Medically necessary 3D or intensity modulated radiotherapy (IMRT) planning is done (77301, ... including dose-volume histograms for target and critical structure partial tolerance specifications).

 7. Your oncologist should perform special planning and mapping to protect multiple critical structures.