Wiki 77014 Review

The physician should be reviewing the images used from the imaging system and the shifts per the comparison to the planned images from dosimetry. If this is for CBCT at time of treatment the imaging system will have a slice in the various planes as compared to the images of similar planes from dosimetry as selected for use with IGRT and the treatment delivery. Physician approval should be evident on the images themselves to support the work and timing to determine if the professional component is billable.
 
CBCT Review

What are the CBCT{Xvi} review requirements are as far as physician daily review? Does a single screenshot review /sign off ?
 
The physician needs to review the imaging in the system, to see the current image in relation to the dosimetry planned image and the shifts as indicated by the software. The approval would occur in Offline Review, Images etc. where the physician can indicate approval or changes needed or the shifts not accepted. They would login and apply their approval. The timing will depend on your internal policy for physician review. Best practice, they review prior to corresponding treatment since the imaging and shifts will be repeated at next fraction of treatment and that treatment position based on those images and not the prior fraction. At very least the same date from a date of service support of charge. Some use by next fraction, which typically means a different date of service.
 
Along the same lines, we are hospital outpatient, the patient came in, got on the table, we did the CBCT (77014) but the provider opted not to treat because the patient's bowel was too full. Can we still charge the 77014?
 
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