Wiki IGRT

[christie.elam@epic-care.com]

I have a question that I cannot seem to get clear guidance on. IGRT images need to be approved by the Radiation Oncologist before their next treatment.

Images are taken the day of treatment and I would assume they need to be approved before that day's treatment. Not approved before "tomorrow's" treatment. All I can find is that vague statement stating "...before their next treatment". Any advice on how to advise my physicians?

 

[sls314]

I have a question that I cannot seem to get clear guidance on. IGRT images need to be approved by the Radiation Oncologist before their next treatment.

Images are taken the day of treatment and I would assume they need to be approved before that day's treatment. Not approved before "tomorrow's" treatment. All I can find is that vague statement stating "...before their next treatment". Any advice on how to advise my physicians?

The images must be reviewed and approved prior to the next treatment session. Also, any necessary patient repositioning must be communicated to the therapist before the next treatment is initiated.

If that is not done, then the physician cannot bill for the professional component of the IGRT.

Do you have access to the ASTRO Coding Resource? It is very helpful for both coding and technical questions from a coding perspective. I highly recommend your practice purchase a copy if you don't already have one.

The American College of Radiology also has a Practice Parameter for Image-Guided Radiation Therapy (IGRT) that you might find helpful. There's a section listing the responsibilities of the Radiation Oncologist - I'm posting the link to the whole document and also a screenshot from page 4 that might be helpful to you.

https://gravitas.acr.org/PPTS/DownloadPreviewDocument?ReleaseId=2&DocId=49

 

[sls314]

Forgot to add, if you don't have the full ASTRO Coding Resource, they do have some FAQ on the ASTRO website as well.

Here's a link to the IGRT FAQ and also a screenshot of some of the relevant questions: https://www.astro.org/practice-supp...ing/coding-guidance/coding-faqs-and-tips/igrt

 

[christie.elam@epic-care.com]

The images must be reviewed and approved prior to the next treatment session. Also, any necessary patient repositioning must be communicated to the therapist before the next treatment is initiated.

If that is not done, then the physician cannot bill for the professional component of the IGRT.

Do you have access to the ASTRO Coding Resource? It is very helpful for both coding and technical questions from a coding perspective. I highly recommend your practice purchase a copy if you don't already have one.

The American College of Radiology also has a Practice Parameter for Image-Guided Radiation Therapy (IGRT) that you might find helpful. There's a section listing the responsibilities of the Radiation Oncologist - I'm posting the link to the whole document and also a screenshot from page 4 that might be helpful to you.

https://gravitas.acr.org/PPTS/DownloadPreviewDocument?ReleaseId=2&DocId=49

View attachment 7830

Thank you, but what does "before the next treatment" mean? The day the IGRT and day of treatment? OR as my radiation oncologists state that they can approve the next day before the next treatment; but they do another IGRT that day too before treatment.

 

[christie.elam@epic-care.com]

Thank you, but what does "before the next treatment" mean? The day the IGRT and day of treatment? OR as my radiation oncologists state that they can approve the next day before the next treatment; but they do another IGRT that day too before treatment.

I am trying to convince them that the image needs to be approved the day of treatment. IGRT done today and treatment done today

 

[sls314]

Thank you, but what does "before the next treatment" mean? The day the IGRT and day of treatment? OR as my radiation oncologists state that they can approve the next day before the next treatment; but they do another IGRT that day too before treatment.

It means before the next treatment. If you have treatment on Monday, the images must be reviewed and approved before Tuesday's treatment.

There were some examples of that in the screenshots I posed above - for example, the ASTRO FAQ where the question was about Friday treatment and Monday reviewing the images. Or the ACR Practice Parameter where it references that the images can be reviewed between treatments, immediately before a treatment, or in real time during treatment.