Tuesday, June 22, 2010

Radiology bundled services Procedure codes

BILLING FOR RADIATION TREATMENTS

The provider must indicate on the claim the number of fractions being billed. When payment is
being made for weekly treatment management, separate payment cannot be made for the
services listed below when rendered by radiation oncologists or in conjunction with radiation
therapy.

In addition, the radiation oncology codes for both teletherapy and brachytherapy include normal
follow-up care during the course of treatment and for three months following its completion.
Hospital discharge day management is bundled into the procedure codes as well.

The following initial and subsequent hospital care codes 99221, 99222, 99223, 99231, 99232
and 99233 are bundled into the payments for the clinical brachytherapy procedures along with
the following:


11920 Tattooing, intradermal introduction of insoluble opaque pigments to correct color
defects of skin; 6.0 sq. cm or less
11921 6.1 to 20.0 sq. cm
11922 each additional 20.0 sq. cm
16000 Initial treatment, first-degree burn, when no more than local treatment is required
16010 Dressings and/or debridement, initial or subsequent; under anesthesia, small
16015 under anesthesia, medium or large, or with major debridement
16020 without anesthesia, office or hospital, small
16025 without anesthesia, medium (e.g., whole face or whole extremity)
16030 without anesthesia, large (e.g. more than one extremity)
36425 Venipuncture, cut down age 1 or over
53670 Catheterization, urethra; simple
53675 complicated (may include difficult removal of balloon catheter)
99211 Office or other outpatient visit, established patient; Level l
99212 Level II
99213 Level III
99214 Level IV
99215 Level V
99238 Hospital discharge day management
99281 Emergency department visit, new or established patient; Level I
99282 Level II
99283 Level Ill
99284 Level IV
99285 Level V
90780 IV infusion therapy, administered by physician or under direct supervision of
physician; up to one hour
90781 each additional hour, up to eight (8) hours
90847 Family medical psychotherapy (conjoint psychotherapy) by a physician, with
continuing medical diagnostic evaluation, and drug management when indicated
99050 Services requested after office hours in addition to basic service
99052 Services requested between 10:00 p.m. and 8:00 a.m. in addition to the basic
service
99054 Services requested on Sundays and holidays in addition to basic service
99058 Office services provided on an emergency basis
99071 Educational supplies, such as books, tapes and pamphlets, provided by the
physician for the patient's education at cost to physician
99090 Analysis of information data stored in computers (e.g., ECG, blood pressures,
hematologic data)
99185 Hypothermia; regional
99371 Telephone call by a physician to patient or for consultation or medical management
or for coordinating medical management with other health care professionals; simple
or brief (e.g., to report on tests and/or laboratory results, to clarify or alter previous
instructions, to integrate new information from other health professionals into the
medical treatment plan, or to adjust therapy)
99372 intermediate (e.g., to provide advice to an established patient on a new problem,
to initiate therapy that can be handled by telephone, to discuss test results in
detail, to coordinate medical management of a new problem in an established
patient, to discuss and evaluate new information and details, or to initiate a new
plan of care)
99373 complex or lengthy (e.g., lengthy counseling session with anxious or distraught
patient, detailed or prolonged discussion with family members regarding
seriously ill patient, lengthy communication necessary to coordinate complex
services or several different health professionals working on different aspects of
the total patient care plan)
· Anesthesia (whatever code billed)
· Care of infected skin (whatever code billed)
· Checking of treatment charts
· Verification of dosage as needed (whatever code billed)
· Continued patient evaluation, examination, written progress notes, as needed (whatever
code billed)

·Final physical examination (whatever code billed)
· Medical prescription writing (whatever code billed)
· Nutritional counseling (whatever code billed)
· Pain management (whatever code billed)
· Review and revision of treatment plan (whatever code billed)
· Routine medical management of unrelated problem (whatever code billed)
· Special care of ostomy (whatever code billed)
· Written reports, progress notes (whatever code billed)
· Follow-up examination and care for 90 days after last treatment (whatever code billed)

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