Amar Rewari, Chief of Radiation Oncology at Luminis Health, shared a post on LinkedIn:
“I was interviewed by Oncology News Central to share practical tips and guidance on how radiation oncology practices should navigate the new CPT delivery code changes.
One important point I emphasized is that these are not entirely new codes.
‘77402, 77407 and 77412 aren’t new code numbers. Existing delivery CPT code numbers for 3D-CRT were revised to include delivery services for IMRT, as well as other changes included in the code descriptions.’
With implementation now underway, the biggest risk I see is inadequate preparation. My advice is simple but critical: ‘documentation, documentation, documentation.‘ Practices need to clearly justify medical necessity with private payers and ‘insert the clear coding language from the CPT manual highlighted.’
Communication with payers also matters. When challenges arise, I recommend that teams ‘ask what documentation is necessary to avoid unnecessary and burdensome delays or denials’ during peer-to-peer discussions or payer conversations.
We are also continuing to work with payors and radiology benefit managers to ensure that the professional component of IGRT services using 77387 remains separately reportable, and to confirm that 77412 can continue to be billed when practices are performing active motion management techniques such as DIBH.
Finally, this is not a set it and forget it transition. ‘Work with your hospital IT systems to ensure proper coding changes and track your denials and payments carefully for the next several months to make sure you are not receiving incorrect denials or payments.’
The bottom line is that ‘being vigilant and proactive during this transition process will be key.’
If you are responsible for clinical operations, billing, or revenue cycle performance in radiation oncology, now is the time to be paying very close attention.
You can read the full article.”
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