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Answers to Compliance and Medical Coding Questions.
  1. Julie Posted 6 month(s) agoRelated Topics

    Is there any written Medicare guidance stating that Interventional Radiologist cannot bill and/or receive payment for CPT 77295, 3D Planning and if they do, they will not be paid. We have heard that only Rad Oncs and Physicists can bill and be paid for this code. We cannot find any guidance stating this and no evidence that IRs do NOT receive payment. Can you confirm guidance on this?

  2. SuperCoder Posted 6 month(s) ago

    Hi,

     

    Please find undermentioned link for the reference to above query

    https://www.acr.org/~/media/ACR/Documents/PDF/Economics/HOPPS/2016/HOPPS-2016-PR-Comment-Letter.pdf

    https://www.acr.org/~/media/ACR/Documents/PDF/Economics/Medicare/MPFS-PR-2014-ACR-Comments-FINAL.pdf

    Hope this helps!

    Feel free to ask further queries.

  3. Julie Posted 6 month(s) ago

    The links were not at all helpful. I'm asking if interventional radiologists are allowed to bill and receive payment for CPT 77295.

  4. SuperCoder Posted 5 month(s) ago

    Hi,

    There is no specific guideline provided by CMS on the payment of CPT 77295 when performed by Interventional Radiologist. Kindly refer to the medical documentation for the below mentioned conflicts

    • Check the NCCI edit for the codes billed along with 77295 on the same claim.
    • No inappropriate code combinations billed.
    • Also, check with your respective payer for reimbursement guidelines for CPT code 77295.

    Hope this helps! 

About this Question

  • Posted by 89082 Julie, 6 month(s) ago. There are 4 posts. The latest reply is from SuperCoder.