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coding for breathing gated IGRT radiation oncology

sean Posted Thu 05th of December, 2019 13:59:19 PM
What codes are used for the IGRT component of radiation daily treatment, such as for respiratory gated radiation treatment: For the professional component (not the technical component), in a free standing center, is it G6002 if x-rays are being used for verification? If G6017 is used as the technical, would G6002 be billed in addition to this to reflect the professional? Instead of G6002, would 77387 be a suitable alternative subject to institute specific preference, with a notable different being that it is not reimbursed under the MPFS? Instead of G6002 could 77014 be used, or would additional criteria be needed?
SuperCoder Answered Fri 06th of December, 2019 05:38:06 AM

Hi Sean,

 

Thanks for your question.

 

Report code G6002 when the provider conducts stereoscopic X–ray guidance to localize the tumor target before initiating the stereotactic radiotherapy for the treatment of tumors.

 

Report code G6017 when the provider uses methods such as three dimensional positional or surface tracking or gating in a single session to localize and track the target of radiation treatment.

 

You may report code G6002 for both professional as well as technical component. If provider performed professional component, append modifier 26 and if provider performed technical component, append modifier TC.

 

Code 77387 has both a technical component (TC) and a professional component (PC), which was not bundled into the conventional radiation therapy treatment delivery code set. If image guidance is required during conventional radiation therapy treatment delivery, both the TC and PC of the IGRT should be reported.

 

A provider may use either G6002 or G6017. There is CCI edit between these two codes. So, you should report only one code at a time during the same session unless you prove medical necessity to report both the codes.

 

Note: Use G codes to represent temporary procedures and professional services. Medicare covers the G codes for the services that replace CPT® codes.

 

Please feel free to write if you have any question.

 

Thanks

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