During the monthly billing reconciliation at a busy radiation oncology clinic, a therapist notices that the charge-capture system posted a cone-beam CT charge for every fraction of the past week. Cone-beam CT was used only on the first and last fractions, while planar portal images were taken on the other days, as confirmed by the daily imaging notes. Which correction to the posted charges should be made before the batch is released?

The correction should make the charges match the imaging performed and documented on each date of service: cone-beam CT on the first and last fractions, and planar portal imaging on the other fractions. Billing portal imaging for every fraction recognizes that image guidance occurred throughout the week, but treats different modalities as interchangeable; it would misstate the service on the dates when cone-beam CT was performed. Following the treatment plan’s routine schedule instead of the daily notes would also be inaccurate: the documented cone-beam CT on the last fraction must be reflected, even if the routine schedule anticipates portal imaging after the first fraction. Consolidating the week’s cone-beam CT services into one charge dated on the final fraction would place services on the wrong dates and fail to represent what was performed on each date; retaining portal charges for the other dates does not correct that mismatch. Exam caveat: distinguish the fact that image guidance occurred from the specific modality used and its date, since a shared clinical purpose does not make imaging services interchangeable for charge capture. Practical check: reconcile each fraction’s imaging entry in the daily notes with the charge for that date before releasing the batch.