Tuesday, June 22, 2010

PROFESSIONAL COMPONENT and Technical component of Radiology billing

PROFESSIONAL COMPONENT

The code used to bill the professional component of radiation therapy services (77427)
represents weekly radiotherapy management services at all energy levels. Since this code
represents a weekly service, bill the first date of the weekly service and include the number of
treatments in the number of service field, 24G. This code allows 3, 4, or 5 number of services.
Submit each weekly treatment on individual lines for each week.

If the entire service includes only one or two treatments during that week, use procedure code
77431. Again, bill the first date of the weekly service and the number of treatments (1 or 2) in
the number of service field. Do not submit this code with modifier 26.


TECHNICAL COMPONENT

The codes used for billing the technical component of radiation therapy (77401, 77402, 77403,
77404, 77406, 77407, 77408, 77409, 77411, 77412, 77413, 77414, 77416, 77417) each
represent an individual daily service. For example, code 77401 represents “Radiation treatment
delivery, superficial and/or ortho voltage provided on one day.”

If you provide this service on two consecutive days, you must bill for two dates of service. You
may bill a range of dates if the number of services matches the range of dates. If the range of
dates do not match the number of services, submit each service on individual lines. Do not
submit these codes with modifier TC.

The technical component of radiology services provided during an inpatient stay may be billed
only by the hospital. Radiology suppliers that render services to beneficiaries in an inpatient
stay shall not bill the Medicare carrier for the technical portion of the service.

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