CPT Knowledgebase - Jan 12, 2011

Please clarify the proper quantity of units to report for code 77338, Multi-leaf collimator (MLC) device(s) for intensity modulated radiation therapy (IMRT), design and construction per IMRT plan, for outpatient hospital facility billing in terms of the number of devices designed and constructed. The reporting of code 77338 once per IMRT plan, regardless of the number of devices constructed, may be appropriate for the physician service, however, is it appropriate for hospitals to report code 77338 only once? Previously, if nine custom devices were created, hospitals reported code 77334, Treatment devices, design and construction; complex (irregular blocks, special shields, compensators, wedges, molds or casts), with nine units. The Medicare Ambulatory Payment Classification (APC) value for code 77338 is the same as the APC value for code 77334, which can be billed with multiple units. CPT Changes: An Insiders View 2010, gives an example with the construction of nine custom MLC devices, but it does not code the scenario with a quantity (ie, units = 1 or units = 9) for the facility setting.

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