Parman reminds readers to recall the definition of consultation: It's a request from one physician to another physician for an opinion or advice. If the patient is sent to "evaluate and treat," then it is a new patient visit. Hause reminds coders that if documented counseling and coordination of care comprises more than 50 percent of the time the radiation oncologist spends face-to-face with the patient as it often does then time would determine the E/M level billed.
Due to the intensity of this visit, if the service was completely documented, it would almost always be assigned the most extensive CPT code, 99205 (New patient; office or other outpatient visit) or 99245 (Office consultation for a new or established patient). Step 2: Clinical Treatment Planning Once radiation oncologists decide to treat the prostate cancer patient with brachytherapy, Hause says, they will embark on an in-depth treatment planning process. The process includes interpretation of special testing that may have been done, prostate localization and other procedures. "The vast majority of brachytherapy treatment plans will be coded 77263 (Therapeutic radiology treatment planning; complex)," he says. The American Medical Association added a new code to CPT Codes in 2000 to describe an additional study done in brachytherapy treatment planning. The urologist or the radiation oncologist may perform 76873 (Echography, transrectal; prostate volume study for brachytherapy treatment planning [separate procedure]). "It's for volume and mapping, and gives the physician an idea of where to insert the catheter for the prostate seeds," says Craig McNabb, MBA, BSN, reimbursement manager for radiation for [...]