Wiki BILLING CPT 77014

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hwc4me4ever

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Looking for guidance when billing CPT 77014 to different payers. Does anyone have any experience billing CPT 77014 26 to Humana? I have not worked with this code and this payer and not confident with it.
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DJ
 
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I have been having issues with Humana denying 77014-26 when billed within 14 days of 77301-26. They are stating 77014 is bundled. While this is true for the technical component, the professional component should not be bundled unless a simulation was provided on the same day or the same day as IMRT planning. ASTRO is advocating for Humana to update their policy. As of now nothing has been updated that I am aware of. I have also tried to bill as 77387 since Aetna will not accept 77014 when billed for IMRT either. Humana has denied this as well. No trouble with any other treatment modalities, just IMRT.

Amerihealth Caritas has also denied for the same reasons. I was informed by a rep their policy was updated 5/31/2020 to remove this edit. So hopefully Humana will follow behind.
 
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Different payors want the 77387 rather than the 77014. Just curious are you a freestanding clinic or a hospital? I work at a free standing clinic. Some payors won't pay the 77014 if it is billed within x number of days within the 77301 (as Jessica0209 stated). It has been an on-going issue. Literally just posted a couple weeks ago
CMS corrects inappropriate denials associated with CT image guidance May 26, 2020
 
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