Gfunk6

And to think . . . I hesitated
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Do any of you bill a Special Physics Consult (77370) for diagnostic image fusion with your planning CT? We have not as our research has determined that this is not a legitimate charge. However, it has come to my attention that this is widely practice in my area.

I'm curious what you do in your centers/institutions. Please share.
 

seper

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I only use that selectively (e.g. when deformable image registration was required).
 

medgator

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Nope, only if physics is assessing previous xrt with via fusion of dicom files from another practice or if we use velocity with deformable registration
 
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BobbyHeenan

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We bill professional fees only in my practice, but I did ask my physicists. They say that if they do a deformable registration using Velocity then they do bill the 77370 code. Our physicists are very liberal on billing this code as I recall though, so I would say more than the majority of fusions they are billing this code. I would be comfortable with me or dosimetry doing easy fusions, but the hospital policy is for only physicists to do fusions, I suspect so that they can bill this code.

I bill a 77399-26 for image fusions. However, it is my understanding that not all insurers actually reimburse us on this code.
 
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BobbyHeenan

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Not that it matters, but we just had a billing consultant roll through our department (ugh), and there was no mention of over billing for that 77370 code. However, they gave us asinine recommendations on ridiculous amounts of documentation/dictations for treatment planning notes, CT sim notes, daily IGRT notes (seriously), etc and threw fits over templated notes.
 
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napoleondynamite

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Pretty sure my physicist bills that every time we do fusion. We have MIM and deform everything for fusion, not sure if that matters?
 

user_name

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As I have been told in two different practices in two different states, the fusion MUST be done by physicist to be billed. If your dosimetrist fuses an MRI to a PET to a preoperative CT to your planning CT, you cannot bill it. The labor doesn't matter. The physicist fusing a single study to your planning CT can be billed. My physicist doesn't like the ambiguity and feels like the payment is too small to risk it, so he doesn't charge it.

BobbyHeenan, I just had the same consultant teleconference earlier this week. You must hit about 51 metrics in every note BUT you better not use a template! I hope you have a better memory than mine when dictating extemporaneously all 42 notes from earlier in the day. If you figure out how to do it, send me the secret.