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Amy Posted Thu 23rd of January, 2014 14:37:20 PM

CPT 77790; if the Rad onc is in the exam room supervising as the patient is either swallowing a capsule or being infused with the radioactive source, and is not handling nor loading the source does this justify coding 77790?

SuperCoder Answered Fri 24th of January, 2014 08:14:58 AM

This doesn’t sounds like a 77790 service. Payers typically say the code only applies to manual loading, LDR brachytherapy.

CPT Assistant Sept 2005:
“Code 77790, Supervision, handling, loading of radiation source, is reported for supervision, handling, and loading of radioelements and is applicable to LDR brachytherapy loading only. This service includes receipt, accounting, handling, and storage of the material. This code also includes custom preparation of the radioactive sources for loading (eg, Iridium-192 seeds in ribbons, Cesium-137 sources into tubes, or loading permanent Iodine-125 or Palladium-103 into cartridges). It is used to describe work associated with LDR brachytherapy.”

According to ASTRO (https://www.astro.org/Practice-Management/Radiation-Oncology-Coding/Coding-Guidance/Brachytherapy.aspx):
“CPT code 77790 is the supervision, handling and loading code used for LDR services prior to insertion of the radioactive source. It appears that any combination of those actions (supervising, handling and/or loading) are sufficient to bill for this code. For example, needles for LDR prostate implants would not typically be loaded by the physician, but are often pre loaded by vendors or physicists. The procedure is supervised, and then usually also handled by the physician, and the code would be appropriately utilized. On the other hand, all three may be performed by the physician for a Fletcher-Suit LDR implant. It is not reportable for HDR procedures.”

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