Wiki Billing IMRT planning 77301 same date as E&M

[kathleeng]

I know that stimulations cannot be billed on same DOS as E&M codes, unless of course separate and significant, however I'm not finding a clear answer regarding billing IMRT planning 77301 on same DOS as an E&M code. My thought, is no, however our doctors are requesting documentation of this and for some reason I'm not finding a resource specifically to this circumstance. Does anyone have any information to this?

 

[suzannel]

Asked around for this, and here's what an expert told me:

As with simulations, you should not report an E/M service on the same service date as IMRT planning. Per Medicare and Medicaid CCI edit rule for standards of medical / surgical practice, the E/M service is a column 2 code for the IMRT planning service. It does indicate a modifier may be used to override the edit under appropriate circumstances.

 

[kathleeng]

Asked around for this, and here's what an expert told me:

As with simulations, you should not report an E/M service on the same service date as IMRT planning. Per Medicare and Medicaid CCI edit rule for standards of medical / surgical practice, the E/M service is a column 2 code for the IMRT planning service. It does indicate a modifier may be used to override the edit under appropriate circumstances.

Thank you for searching an answer on this. I appreciate it!