Learn all about Radiation Oncology CPT Codes and Billing Coding Guidelines. Radiation Oncology is a specialty that involves treatment of various forms of Cancer through radiation. This forms of therapy use carefully selected targeted and regulated doses for the process of killing cancer cells.

The cancer cells normally die as a result of destruction of chromosomes and DNA, preventing them from further growing, thus preventing a tumor from growing.

Radiation Oncology CPT Codes and Billing Coding Guidelines

For proper reimbursement from insurance companies, Medical Billing staff working for a Radiologist, Oncologist or Radiology Practice need to document proper disease and diagnosis coding through the use of ICD and CPT codes.

Radiation Oncology CPT Codes and Billing Coding Guidelines

Radiology CPT codes comprise of 70,000 series of codes that are normally organized depending on the type of radiology and the purpose of the service. Radiation oncology CPT code are normally classified as shown below:
  • Diagnostic Radiology CPT Codes 70000 - 76499
  • Diagnostic Ultrasound CPT Codes 76500 - 76999
  • Radiologic Guidance CPT Codes 77001 - 77032
  • Breast, Mammography CPT Codes 77051 - 77059
  • Bone/Joint Studies CPT Codes 77071 - 77084
  • Radiation Oncology CPT Codes 77261 - 77999
  • Nuclear Medicine CPT/HCPCS Codes 78000 – 79999
Two CPT codes are primarily used for reporting Intensity Modulated Radiation Therapy (IMRT). CPT Code 77301 for Radiotherapy dose planning, and CPT Code 77418 for Radiotherapy treatment delivery.

Radiation CPT code 77301 is commonly utilized as an intensity modulated radiotherapy plan that includes dose volume histograms for target and critical structure partial tolerance specifications.

Radiation CPT code 77418 is one the other hand normally used as a delivery single or multiple fields/arcs via narrow spatially and temporary modulated beams. CPT code 77418 is a technical-component only code which can be used by physicians when services are performed in a non-facility setting such as the office.

Billing Radiation Oncology Services

Radiological service can be billed for the physician's work as well as the use of equipment or supplies. The technical component (TC) includes facility charges, equipment, supplies, pre/post injection services, staff and so on. The professional component (PC) involves studying and making inferences about the radiological test and submitting a written report with the findings.

Radiation Oncology CPT Code Modifiers

Modifiers are used to signify the technical and professional components in a radiological service. They are 2-digit numbers that are used to explain a procedure in more detail. They can indicate repeat or multiple procedures, such as radiography performed bilaterally. When billing for the technical component only, the modifier 52 has to be used; when billing only for the professional component, the modifier 26 is to be used. In the latter case, a written report by the physician providing the services is required to avoid claim denial.

Some of the main challenges that radiologists face include understatement of procedures carried that many at times result in insufficient reimbursement. On the other hand overstatement might result in risk of abuse repayments and fines.

Radiologists can resolve all these issues by going in for the services of professional medical coding companies. That's why Radiology Practices need professional Medical Billers skilled to document correct ICD and CPT coders to do the job.

You can also checkout Echocardiogram CPT Codes, CPT codes for MRI of Brain, Breast, Lumbar Spine and Shoulder, Cardiology CPT Changes and other Medical Billing and Coding Updates 2014 to learn further.

Effective reimbursement of Radiation Oncology services, in-depth knowledge of the medical billing coding systems, application of coding principles, and thorough understanding of documentation is required. That's why most of the professional companies utilize Best Medical Billing Softwares to guarantee efficiency and accuracy in billing and coding, for checking local coverage determination and so on to ensure that all claims are reimbursed.

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