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Oncology & Hematology Coding Alert

News Brief:

NCCI 9.3 Bundles Basic and Special Dosimetry

Published on Thu Jan 01, 2004

The National Correct Coding Initiative, version 9.3, which took effect Oct. 1, will not have a major impact on oncology practices.
 
NCCI contained only one oncology-related edit: CMS now bundles code 77331 (Special dosimetry [e.g., TLD, microdosimetry] [specify], only when prescribed by the treating physician) into 77300 (Basic radiation dosimetry calculation, central axis depth dose calculation, TDF, NSD, gap calculation, off axis factor, tissue inhomogeneity factors, calculation of nonionizing radiation surface and depth dose, as required during course of treatment, only when prescribed by the treating physician), says Linda L. Lively, MHA, CCS-P, RCC, CHBME, founder and CEO of American Medical Accounting and Consulting in Marietta, Ga.
 
The edit means that when the radiation oncologist performs basic and special dosimetry on the same patient on the same day, you can't bill 77300 and 77331 together. Also, NCCI classifies the edit as mutually exclusive, so you can't use modifier -59 (Distinct procedural service) to unbundle the codes, Lively says.
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