2-C-3: Charge Capture And Current Procedural Terminology Flashcards
What are professional charges?
Professional charges are for the patient care procedures that involve the radiation oncologist.
What are technical charges?
Technical charges are for other patient care procedures that do not involve the radiation oncologist.
What are the billing principles of CPT?
Patients are billed for the treatments they get, the devices they use, and their simulations.
How can billing codes be categorized?
Billing codes can be broken down into three categories: simple, intermediate, and complex.
What are simple devices?
Simple devices are devices that can be used for multiple patients.
Examples: prone pillow, Duncan mask, wing board.
What are intermediate devices?
Intermediate devices are devices that can be indexed and have multiple pieces.
What are complex devices?
Complex devices are devices that are custom made and can be used for only one patient.
Examples: Vac-lok, Alpha Cradles, Aquaplast masks.
Do devices used for patient comfort require a billing charge?
No, devices used for patient comfort do not require a billing charge.
Examples: pillows and mats.
How often are devices billed to the patient?
Devices are billed to the patient only once.
What is a simple simulation?
A simple simulation is a simulation of a single treatment site without any custom blocking.
What is billed during simulation verification?
When patients come back for their simulation verification, or dry run prior to the start of treatment, this will be billed as a simple simulation.
What is an intermediate simulation?
An intermediate simulation is for two or more treatment sites.
What is a complex simulation?
A complex simulation is for treatments using arc therapy, complex or custom blocking, or three or more treatment sites.
What defines a simple treatment?
A simple treatment is a single treatment area with only one or two treatment fields and fewer than two simple blocks.
What defines intermediate treatment fields?
Intermediate treatment fields are two separate treatment areas and can have at least three treatment fields and three simple blocks.
What defines complex treatments?
Complex treatments can be three or more treatment areas and use custom blocks, tangential fields, wedges, arcs, field-in-field, or electron beams.
What is the charge for weekly port images?
Patients are billed a separate charge for their weekly port images.
What is required for complex treatments that involve IGRT?
If patients are having a complex treatment that requires IGRT (image-guided radiation therapy), they must be billed for that daily as well.
What is the billing for IMRT?
IMRT (intensity modulated radiation therapy) has its own charge as well.
IMRT simple is billed for breast and prostate; IMRT complex is for all other IMRT cases.
