CPT code 77290 is used for complex radiation therapy field setup, involving detailed planning and precise positioning to ensure effective treatment.
CPT code 77290 is used to describe the process of setting a complex radiation therapy field. This involves the detailed planning and precise configuration of the radiation treatment area to ensure that the radiation is accurately targeted to the specific area requiring treatment, while minimizing exposure to surrounding healthy tissues. This code is typically used when the treatment plan involves intricate techniques or multiple treatment areas, requiring a higher level of expertise and planning.
For CPT codes 77285 and 77290, which pertain to setting radiation therapy fields, the following modifiers may be applicable:
1. Modifier 26 (Professional Component): This modifier is used when the service provided is the professional component of the procedure, such as the interpretation of results or the planning aspect of the radiation therapy.
2. Modifier TC (Technical Component): This modifier is used when the service provided is the technical component, which involves the use of equipment and technical staff to perform the procedure.
3. Modifier 59 (Distinct Procedural Service): This modifier may be used if the procedure is distinct or independent from other services performed on the same day. It indicates that the procedure is not part of a more comprehensive service.
4. Modifier 76 (Repeat Procedure by Same Physician): This modifier is applicable if the same physician repeats the procedure on the same day for the same patient.
5. Modifier 77 (Repeat Procedure by Another Physician): This modifier is used when a procedure is repeated on the same day by a different physician.
6. Modifier 78 (Unplanned Return to the Operating/Procedure Room): This modifier is applicable if there is an unplanned return to the procedure room for a related procedure during the postoperative period.
7. Modifier 79 (Unrelated Procedure or Service by the Same Physician): This modifier is used when an unrelated procedure is performed by the same physician during the postoperative period.
These modifiers help clarify the nature of the service provided and ensure accurate billing and reimbursement for the healthcare provider. It is important to use them appropriately to reflect the specific circumstances of the service rendered.
CPT code 77290 is reimbursed by Medicare, but the reimbursement specifics can vary based on several factors.
The Medicare Physician Fee Schedule (MPFS) provides the payment rates for services covered under Medicare Part B, including CPT code 77290.
However, the actual reimbursement amount can differ depending on the geographical location and the policies of the local Medicare Administrative Contractor (MAC).
Each MAC is responsible for processing claims and setting local coverage determinations, which can influence the reimbursement rate for CPT code 77290.
Therefore, healthcare providers should consult the MPFS and their respective MAC for precise reimbursement details related to this code.
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