Wiki CPT 77280 bundled with 77301

[daragan]

We received notice that simple sims 77280 are now going to be bundled into the APC payment for IMRT planning services. Are we to take it that the professional component is also bundled as we can still bill the professional component of the imaging 77014,26 but not the technical side?

 

[rcrouch@crmchealth.org]

I do not bill professional component, only facility charges but I ran the edits for the professional side through MedAssets and it is showing bundled under the professional component also - 77280 is a part of 77301.

Rhonda Crouch, CPC, CHONC

 

[KMayercsik]

77014 has already been bundled into 77280- 77290; neither code now exists as a billable entity with IMRT 77301.
Regarding the 77280, if done as a preport/verification simulation, prior to starting the actual treatment, it is billable. 77280-77290 (initial set up) is considered bundled if used in developing an IMRT plan
I would suggest contacting your carrier and asking them directly if they have any objection to billing 77290 in conjunction with an IMRT course of therapy. If they say yes, then don't bill it; if they say no, I would continue to bill the code. Get this in writing.

 

[AnnaE]

77280

We received notice that simple sims 77280 are now going to be bundled into the APC payment for IMRT planning services. Are we to take it that the professional component is also bundled as we can still bill the professional component of the imaging 77014,26 but not the technical side?

Hi,

We bill 77280 (verification sim) on the first treatment for IMRT. 77290 is bundled with IMRT plan regardless of the date of service of the IMRT plan. Since billing 77280 is part of the IMRT treatment, not the plan.

Thanks

 

[ghiocel]

CPT 77301 POS 11 -Physician approved remotey-Supervision(general, direct,personal) ?

What type of doctor supervision ( general; direct or personal)for the CPT 77301 or CPT 77295 -treatment planning from dosimetrist and physicist documents is required? The plans are approved remotely by the physicians. Are these plans billable if the physician approved them while he is not in the Center. The Center is free standing facility with POS 11.