Custom Radiation Treatment Specific Billing Audit Sheets

A radiation treatment-specific billing audit sheet is a detailed document used to ensure the accuracy and compliance of billing practices in radiation oncology. The compoents below ensure that radiation oncology billing is accurate, compliante to regulations and properly reimbursed. It typically includes the following components:

1. Patient Information: Basic details about the patient, including name, ID, and insurance information.

2. Treatment Codes: Specific CPT (Current Procedural Terminology) codes for each radiation therapy service provided, such as simulation, treatment planning, and delivery.

3. Date of Service: The exact dates when each service was provided.

4. Documentation Verification: Ensuring that all services billed are supported by appropriate clinical documentation, including physician notes and treatment records.

5. Charge Capture: Verification that all billable services have been captured and coded correctly.

6. Compliance Checks: Ensuring adherence to payer-specific guidelines, including National Correct Coding Initiative (NCCI) edits and Medically Unlikely Edits (MUEs).

7. Modifiers: Correct application of billing modifiers to indicate specific circumstances, such as multiple procedures or bilateral treatments.

8. Authorization and Pre-certification: Verification that necessary authorizations and pre-certifications were obtained before treatment.

9. Audit Trail: A record of who performed the audit, the date of the audit, and any findings or corrections made.

10. Signatures: Sign-off by the auditor and relevant staff to confirm the audit’s completion and accuracy.