Wiki New rad/onc biller

[mfranks]

Does anyone have any advice for billing CPT code 77263? I am very new to a proton therapy group and unfortunatly there were no other billers before me so there is no protocol on how I should be doing this. I have some doctors that are wanting to bill for this CPT on the date the patient has their simulation done, but the document is not dated for the same day. Do we bill this code off the date on the form or on the date of simulation?

 

[dlewis72]

Treatment Planning 77263 can happen before the sim or the same day of the simulation. So you can bill using either date.

If you need further help you can send a private message.

Hope this helps.

 

[egraham1827]

The CPT can be billed on the date it was done/date of service on report. It does not necessarily need to be billed with the initial. If the CTP and sim are done on the same date, it is ok to bill both codes, no modifier needed.

 

[astuart@pmsia.com]

As the others stated, you can bill the 77263 on the same date as the initial simulation but you also need to have documentation to support it on the date that you choose to bill it. The 77263 represents that physician's "thought process" of how they are planning on treating the patient. Be definition this would need to be done fairly upfront and definitely prior to the actual isodose planning. We recommend that our physicians dictation on the day of the initial simulation because that is when the physician is first evaluating how that are planning on treating the patient.
Hope this helps.

Alanna M Stuart BS RT(R)(T), CPC, ROCC, CHONC
Medical Billing Coder/Auditor
Physicians Management Services of Iowa
315 Walnut Street
Atlantic, IA 50022
712-243-7030
astuart@pmsia.com