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- Dec 18, 2015
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MEDICARE IMPROPERLY PAID HOSPITALS MILLIONS OF DOLLARS FOR INTENSITY-MODULATED RADIATION THERAPY PLANNING SERVICES
OIG report on IMRT... really re: complex sims and IMRT, not IMRT per se. I have often said, "It's a trap!" It really is a trap:
Simulation-aided field setting complex (77290) during a course of IMRT is appropriate for the initial setup of the patient where an immobilization device may be constructed, isocenter(s) and volume of interest are determined, and CT or other imaging is obtained for subsequent reconstruction of target(s) and critical structure(s).
....
Payment for the services identified by CPT codes... 77290... are included in the APC payment for CPT code 77301 (IMRT planning). These codes should not be reported in addition to CPT code 77301 when provided prior to or as part of the development of the IMRT plan.
Truth is truth until new rules are made... of course, the "new rule" that 77290 plus 77301 is verboten is sorta old news now I guess.
OIG report on IMRT... really re: complex sims and IMRT, not IMRT per se. I have often said, "It's a trap!" It really is a trap:
Simulation-aided field setting complex (77290) during a course of IMRT is appropriate for the initial setup of the patient where an immobilization device may be constructed, isocenter(s) and volume of interest are determined, and CT or other imaging is obtained for subsequent reconstruction of target(s) and critical structure(s).
....
Payment for the services identified by CPT codes... 77290... are included in the APC payment for CPT code 77301 (IMRT planning). These codes should not be reported in addition to CPT code 77301 when provided prior to or as part of the development of the IMRT plan.
Truth is truth until new rules are made... of course, the "new rule" that 77290 plus 77301 is verboten is sorta old news now I guess.
