Oncology & Hematology Coding Alert

Question: Which treatment planning code should I report when the radiation oncologist uses a radioactive source to prevent pterygium regrowth?


California Subscriber


Answer: You may report 77261 (Therapeutic radiology treatment planning; simple) for the scenario you describe.

Simple planning covers planning for a single, clearly defined treatment area and doesn't require the oncologist to interpret special tests. The pterygium treatment you describe meets this requirement. The treatment typically involves the oncologist placing a strontium-90 eye applicator over the area for a short time after an ophthalmologist surgically removes the pterygium from the eye.

Term: A pterygium is an abnormal tissue mass arising from the conjunctiva of the eye's inner corner. The mass may obstruct vision by growing over the cornea.

You should report the pterygium with the appropriate five-digit code from the 372.4x range (Pterygium). For example, if the physician documents a progressive peripheral pterygium, you should report 372.41 (Peripheral pterygium, progressive).

The answers for You Be the Coder and Reader Questions were reviewed by Cindy C. Parman, CPC, CPC-H, RCC, co-owner of Coding Strategies Inc. in Powder Springs, Ga., and past-president of the American Academy of Professional Coders National Advisory Board.