Medical Coding

Category - Radiology

ONCOLOGY CLINIC NOTE
PATIENT NAME: Watts, Douglas
AGE: 15
DATE: 07/08/2014
DIAGNOSIS: Mantle Cell Lymphoma in the Neck
TREATMENT: Clinical Treatment Planning stage I including simulation of treatment

The patient was recently diagnosed with mantle cell lymphoma in the neck. He was seen in the clinic today for the first stage of clinical treatment planning. The patient’s first step is to start radiation treatments. Due to the mild nature of the lymphoma, planning will focus on a single treatment area, with a single radiation port and no blocking. The primary care oncologist agrees that this focus is the best way to manage the malignancy before it progresses. No further aggressive treatments are necessary at this time. The patient and his family also agree that this will be a sufficient means of treatment at this time. Simple simulation of single treatment area was completed and the treatment plan seems sufficient.
The patient is scheduled to return to the clinic in two days, after dosimetry calculations have been completed and the total length of time for the radiation treatment has been calculated.

What is the correct code for this service?
  1. 77263, 77280
  2. 77262, 77280
  3. 77261, 77280
  4. 99215, 77280
Explanation
Answer: C - The correct code for this service is 77261(Therapeutic Radiology Treatment Planning; Simple). This procedure is considered simple because the planning focused on a single treatment area and encompassed only a single port and no blocking. Other levels of planning may consist of more extensive treatments such as treatments for more aggressive forms of cancer.
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