Health Information Management

Remember to bill one port film per week or once per five fractions with radiation oncology

APCs Insider, January 11, 2008

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QUESTION: Our business office has seen edits for radiation oncology claims that include port film charges that include more than one port film billed for a date of service? Is this a medically unlikely edit (MUE)?

ANSWER: The edit could be an MUE edit; however, more than likely, your FI has realized that as of February 2006, CPT Assistant guidance for this code limits the appropriate number of units you can bill. According to CPT Assistant, the hospital should only bill one port film per week or once per five fractions, regardless of the number of films taken. Historically, this is how freestanding radiation treatment centers billed and how their Medicare carriers limited the payment for port films. However, hospitals may have billed for each port film taken. The edits are new edits that many FIs are implementing.

CPT Assistant Archives (4th Quarter 1990 to the present)-Copyright American Medical Association articles

Coding Consultation: Questions and Answers (February 2006, Volume 16, Issue 2, pages 16-18)

Question: What is the appropriate code to report for the performance of a therapeutic radiology port film?

AMA Comment: The appropriate code to report is 77417, Therapeutic radiology port film(s). Port films are x-rays taken during the delivery of radiation treatment using the treatment beam of the machine. Port films demonstrate the exact shape, size, and area covered by the treatment beam during an actual treatment. Port films are reported by the facility, once per five fractions or once per week of treatment management per patient, regardless of the number of films required or portals evaluated.



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