adminservices
Contributor
Code 77427, patient has daily radiation treatment and seen by MD weekly for radiation treatment management.
Question:
If MD sees patient on week 1 on a Wednesday for the above then on week 2 sees patient for the above on Tuesday, can we bill 77427 for the 1st week and 2nd week even though it less then 5 treatment days?
Many individuals have different opinions since Cancer Center drops their billing on a weekly basis therefore only one 77427 appears on bill. Would like an correct interpretation according to the below.
According to the Medicare Claims Processing Manual
Chapter 13 - Radiology Services and Other Diagnostic Procedures
Table of Contents
(Rev. 1998, 07-09-10)
Transmittals for Chapter 13
Carriers must pay for a physician's weekly treatment management services under code 77427. Billing entities must indicate on each claim the number of fractions for which payment is sought.
A weekly unit of treatment management is equal to five fractions or treatment sessions. A week for the purpose of making payments under these codes is comprised of five fractions regardless of the actual time period in which the services are furnished.
Question:
If MD sees patient on week 1 on a Wednesday for the above then on week 2 sees patient for the above on Tuesday, can we bill 77427 for the 1st week and 2nd week even though it less then 5 treatment days?
Many individuals have different opinions since Cancer Center drops their billing on a weekly basis therefore only one 77427 appears on bill. Would like an correct interpretation according to the below.
According to the Medicare Claims Processing Manual
Chapter 13 - Radiology Services and Other Diagnostic Procedures
Table of Contents
(Rev. 1998, 07-09-10)
Transmittals for Chapter 13
Carriers must pay for a physician's weekly treatment management services under code 77427. Billing entities must indicate on each claim the number of fractions for which payment is sought.
A weekly unit of treatment management is equal to five fractions or treatment sessions. A week for the purpose of making payments under these codes is comprised of five fractions regardless of the actual time period in which the services are furnished.