77370

Can we bill 77370 for a Radiation Oncologist under a Physician Group.
As we see denials stating invalid Procedure code from Major Insurances.

re: 77370

Special medical radiation physics consultation is only one part of a series of services/procedures that are done on a patient receiving radiation therapy. Clinical treatment planning, simulation-aided field setting, medical radiation physics, treatment delivery, and treatment management are services/procedures that will be billed separately, in addition to this code. Code 77370 has both a technical and professional component. To report only the professional component, append modifier 26. To report only the technical component, append modifier TC. To report the complete procedure (i.e., both the professional and technical components), submit without a modifier.

The use of special radiation measuring and monitoring devices are used (thermoluminescent dosimeters, solid state diode probes). These procedures are selected and done specifically at the request of the radiation oncologist. The physics CPT® codes 77336 and 77370 are considered to be technical in nature. The physician may order and direct that these procedures be performed, but generally has little input into the actual procedure. These measurements are to evaluate a plan and are not done on a daily basis to confirm dose. After these steps have taken place, the patient will then go to the treatment management and delivery phase.

77370    Special medical radiation physics consultation
The medical radiological physicist was called for a consultation to coordinate the complex dose calculations resulting from multiple treatment field interactions. A full consultative report was rendered by the medical radiological physicist. The procedure is ordered by the physician and the results are acknowledged by the physician but the actual performance of this service is carried out exclusively by the physicist.

Code 77370: This code is only billed in special situations. This code is also a technical code. This code requires a detailed written report describing the problem to be given to the requesting physician. This code should be used for consulting purposes when a problem or special situation arises during radiation therapy. This code requires a detailed written report describing the problem to be given to the requesting physician.

CPT® Assistant 2009: Radiology/Radiation Oncology

Question:Can code 77370 be used to report image fusion in the planning process?

Answer:There is no specific CPT® code for radiographic image fusion, which is the process of integrating information from multiple image formats. Code 77370, Special medical radiation physics consultation, may be reported when other image modalities (eg, MRI, PET/CT, ultrasound, or arteriograms) are fused to the CT planning set. To report code 77370, there should be a written order for the procedure. The fusion has to be complete and assessed for anatomic congruence. The medical physicist should generate a report to the radiation oncologist stating the specific patient parameters that were relevant to the fusion process. For MRI fusion work in the body, many times the fusion must be adjusted manually and should be more accurate in the area of interest and less so near peripheral anatomic areas. Also, PET/CT fusions will generally require some manual adjustments to bring the image sets into congruence, and these reports will be more involved. The request is signed and dated by the requesting physician, and the report is dated and signed by the medical physicist.