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Ask a Rev Cycle Expert: Are 77295 and 77280-77290 Bundled?

Question:

When we look up the 3-D planning 77295 along with the 77280/77290, we are not seeing a bundled warning. When we go and look into this a little further, a reference book we use states that teletherapy isodose plan (codes 77306-77307) and simulation (codes 77280-77290), on the same date are bundled. We understand that they are not payable on the same date of service, but does that also mean that they are bundled? This is just not clear.

Answer:

In the National Correct Coding Initiative (NCCI) Procedure-To-Procedure (PTP) edit files posted December 1 and 2, 2020, there are no longer any column 1/column 2 edits between Current Procedural Terminology (CPT®) codes 77280, 77290, and 77295. According to the American Society for Radiation Oncology (ASTRO), the change is due to their work educating the Centers for Medicaid & Medicaid Services (CMS) and the Office of Inspector General (OIG) regarding the different valuation processes used to develop the distinct codes.


Disclaimer: This information was current at the time of its publishing and is designed to provide accurate information in regard to the subject matter covered. Vitalware does not accept any responsibility or liability with regard to any errors, omissions, misuses, or misinterpretation by the reader. It is not intended to take the place of either the written policies or regulations. We encourage you to review the specific regulations and other interpretive materials as necessary. All CPT® codes are trademarked by the American Medical Association (AMA) and all revenue codes are copyrighted by the American Hospital Association (AHA).