Test for FAQ

Can you bill more than 10 calcs (77300) on one day?

No, the MUE on any one date of service is 10. Billing over 10 will most often result in a denial of all calcs, not just the amount over 10.

​Patient has CT for Breast Treatment.  A 3D plan is performed and charged for the initial fields.  The physician wants a new 3D plan for the boost, but does not re CT this patient. What are the appropriate charges to bill on the date the the 3D Boost plan is printed?

You can bill the calcs (77300) and devices(77334) not to exceed 10. If a new CT data set is needed it would be for gross tumor volume change, patient position change or gross patient anatomy change. In your scenario, don’t bill a second 77295. A complex 77307 could be billed if it was a photon boost or a 77321 for electrons.

For IMRT boosts: We have previously been instructed to electronically print the boost, perform calculations and charge for calcs and MLC devices a few days before the boost begins (codes 77338 and 77300). Generally the entire plan is completed before the course of treatment begins but occasionally the plan is changed due to anatomical changes or new diagnostic studies. Please advise what is appropriate in each situation.

This is a facility decision. If you read the AMA clinical Vignettes and the AMA code definition it is thought to be one per plan. PTVs are part of the same plan.

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