Health Information Management

Tip: Correctly report initial patient exam for radiation oncology

APCs Insider, July 12, 2013

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The first step to providing radiation oncology services is the initial patient exam. Coders should report the preliminary consultation, evaluation of the patient prior to the decision to treat, or full medical care when provided by the therapeutic radiologist using the appropriate E/M code (99201-99215; 99241-99255).

Keep in mind that Medicare views the medical necessity for the service to be the overarching criterion for payment of the service in addition to the individual requirements to meet the level of CPT code billed.

This tip is adapted from “Shrink radiation oncology coding confusion” in the June issue of Briefings on APCs.



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