Wiki IMRT/Radiation therapy 77280

[melouise]

We typically perform and bill 77280 the day prior to the patient starting radiation therapy treatment. Our physicist is stating we can perform and bill 77280 the day treatment is started with 77418 & 77421. The CCI edits don't show that the 77280 is bundled with these codes. However one of our therapists is saying if we start billing the 77280 on the same day as the 77421 that we won't be paid for the 77280. Does anyone have any information regarding the billing of these codes together? Thanks

 

[teblizzy]

In order to bill for the verification simulation (77280) on the first date of IMRT there would need to be medical necessity and information gained from the verification simulation, not just imaging. Since you are billing IGRT on that date and using that information to set and deliver the the treatment, the verification sim would need to document other work and information necessary for you to also deliver the treatment which is not imaging related.