Radiology Coding Alert

Question: In intensity modulated radiotherapy, is there a professional component for CPT 77300 and CPT 77334 ? In the past, these were bundled into the 77301 (IMRT) code.

Ohio Subscriber

Answer: Code 77300 isn't bundled with 77301 any more, and only hospitals have to use modifier -59 (Distinct procedural service) when reporting 77334 with 77301.

CMS unbundled 77300 (Basic radiation dosimetry calculation ...) from 77301 (Intensity modulated radiotherapy plan ...) on July 1, 2003. This change is retroactive from April 1, 2002. As a result, you don't need a modifier to report them together - they both pay. 

To report 77334 (Treatment devices, design and construction; complex [irregular blocks, special shields, compensators, wedges, molds or casts]) with 77301, hospitals need to append modifier -59 to indicate that the service is distinct from other services reported on the same day of service. There is no similar instruction for the professional component of treatment devices or for freestanding centers. There is no physician "design" of treatment devices, and the RVUs for the IMRT treatment plan (77301) reportedly include reimbursement for devices created in conjunction with the plan.

Check out CMS Manual Transmittal 132 at
www.cms.hhs.gov/manuals/pm_trans/R132CP.pdf for more information.