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[Announcement] NCCI Will No Longer Allow 77300 and 77295 to be Reported Together

The 2016 National Correct Coding Initiative (NCCI) Policy Manual for Medicare Services was released for services effective January 1, 2016. NCCI is a contractor for the Centers for Medicare and Medicaid Services (CMS) that aims to prevent improper payment when incorrect code combinations are reported.

Beginning January 1, 2016, NCCI will no longer allow the following CPT codes to be reported together:

77300: Basic radiation dosimetry calculation, central axis depth dose calculation, TDF, NSD, gap calculation, off axis factor, tissue inhomogeneity factors, calculation of non-ionizing radiation surface and depth dose, as required during course of treatment, only when prescribed by the treating physician.
77295: 3-dimensional radiotherapy plans, including dose-volume histograms.

 

CMS has implemented an edit on these codes because the agency believes the work of 77300 is integral to the work of 77295, and therefore is not considered a separately reportable procedure. 

The Medical Management Institute – MMI – Medical Coding News & MMI Updates