Wiki Radiation Codes

[sarah.e.harmon@gmail.com]

I am getting a denial that says 77014-26 and 77307 - 26 cannot be billed together. Can someone help?

 

[BenCrocker]

Might want to look here for options and do research.

http://www.radmaxonline.com/news/radmax-news/2015-radiation-oncology-code-changes

 

[teblizzy]

There is an NCCI edit, 77014 cannot be billed on same date as 77307.

 

[Stacyharter98]

Medicaid and 77307

Is anyone having trouble getting Medicaid to pay the new 77307 2015 code?

 

[sarah.e.harmon@gmail.com]

I see in the NCCI edits that 77307 can't be billed with 77401 on the same date of service but nothing about 77014.

 

[ycrownie@gmail.com]

77307

a few of our patients have Emergency Medicaid and I am getting denial for 77307. Medicaid is stating that this code does not support emergency services. How do we move forward?

 

[mitchellde]

I tend to agree with the payer on this one. How does your documentation support this service for emergency use?

 

[ycrownie@gmail.com]

I'm asking a question. 77307 is a new code and if our patient was admitted and needed emergency radiation this is a part of the planning that the Physicist/Dosimetrist use.

 

[astuart@pmsia.com]

I'm asking a question. 77307 is a new code and if our patient was admitted and needed emergency radiation this is a part of the planning that the Physicist/Dosimetrist use.

The problem may come down to the department/place of service. Our Emergency Medicaid policies will only cover services performed in the ED. When the patient enters the Cancer Center or Radiation Department, they are no longer covered. I completely agree with you that there are emergent situations for radiation but unfortunately it usually comes down to legalities. Your best bet would be an appeal including documentation from the rad onc as to why it was emergent. Good Luck!