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Oncology & Hematology Coding Alert

CPT 2001 Revisions Allow for More Specificity In Oncology Billing Procedures
Chemotherapy and radiation oncology CPT codes remain largely as they did in the 2000 editi... Read more
Answer These Six Questions To Reduce Denials and Audits
Poor documentation can put a medical practice in economic jeopardy. If an oncology practi... Read more
Get Paid for Transfusions Performed in the Office
Blood transfusions were once the sole domain of hospital outpatient departments. But more ... Read more
Reader Question:
Consultation vs. Transfer of Care
Question: My understanding is that when billing for a consultation, the choice of words ... Read more
Reader Question:
Aborted Bone Marrow Biopsy
Question: We are a free-standing clinic, and one of our physicians tried to perform a bon... Read more
Reader Question:
Chemotherapy Drugs
Question: The cost of chemotherapy drugs is more than the new APC system will reimburse. H... Read more
You Be the Coder:
Billing When Covering for Another Physician
Question: We have two medical oncologists who cover for each other every other weekend. If... Read more
Use Modifier -26 to Avoid Denials for Diagnostic Testing Procedures
Oncology practices that perform diagnostic testing procedures in a hospital could be overb... Read more
Avoid Audits:
Documentation Is Key for Radiation Treatment Planning
Documenting thoroughly will get oncologists reimbursed for all stages of radiation treatme... Read more
Get Paid for Gemcitabine When Used Off-label
There is increasing evidence that the chemotherapy drug gemcitabine (J9201) approved for ... Read more
Reader Question:
APCs
Question: Are there any codes that are appropriate for central venous access blood draw, c... Read more
Reader Question:
Tamoxifen
Question: I am sure I read somewhere that if a patient with a prior surgical removal of a ... Read more
Reader Question:
New vs. Established Patient
Question: I work with a private oncologist who left a group practice in January 2000. We... Read more
You Be the Coder:
High Dose Radiation
Question: In treating patients with high dose radiation (HDR), the radiation oncologist an... Read more
Bill Separately for Chemotherapy Administration And Supportive-care Drugs to Optimize Payment
Although there is an obvious difference between chemotherapy infusion and supportive-care ... Read more
Reduce Claim Rejection When Billing Two Diagnosis Codes
Physician offices in 10 western and midwestern states no longer are able to list more than... Read more
Use Q Codes for Hospital-Based Chemo Administration
Coders at hospital outpatient cancer treatment facilities should use only Q codes when bil... Read more
Coding in the News:
The Oncologists Role in Treating Skin Cancer
Melanoma is a deadly form of skin cancer that was once again thrust into public view when ... Read more
Reader Question:
New vs. Established Patient
Question: I work with a private oncologist who left a group practice last January. We saw ... Read more
Reader Question:
Family History Consults
Question: Our claims that include a diagnosis of family history consults are being denied.... Read more
You Be the Coder:
Chemotherapy After Surgery
Question: I work for a solo gynecology/oncology physician who performed a major surgery to... Read more
Establish Medical Necessity to Receive Payment For Prothrombin Time
Cancer patients occasionally are at risk of developing blood clots, requiring the administ... Read more
Recoup Chemotherapy Costs With Incident-to Billing
When a physician in your practice is out of the office or taking the day off, but his or h... Read more
Observation Status Rules Unaffected by APCs
Now that ambulatory payment classifications (APCs) have become part of everyday hospital a... Read more
Reader Question:
Coding Multidose Vials
Question: What is the correct way to bill multidose vial drug amounts on a HCFA-1500? If a... Read more
Reader Question:
Family Consults
Question: How can I bill for family meetings in which the patient is not present? New Yor... Read more
You Be the Coder:
Billing Modifier -80 for PA
Test your coding knowledge. Determine how you would code this situation before looking at... Read more
Boost Pay Up by Billing for Wasted Chemotherapy Drugs
The Health Care Financing Administration (HCFA) does not have a written policy to guide on... Read more
Get Appropriate Reimbursement for Port Flush
Oncology practice billing staffs often wrongly assume that the pump and venous access port... Read more
Incident-To Rules Apply:
Be Reimbursed for Nurse-Provided Oncology Services
Oncology is a nursing-intensive specialty. A fair amount of care is given to patients outs... Read more
News Alert:
Drug Reimbursement
If the Health Care Financing Administration (HCFA) has its way, oncology practices could g... Read more
Reader Question:
CT Scanner Billing
Question: The radiation oncologist whom we do billing for is considering the purchase of h... Read more
Reader Question:
Discussing Treatment Options
Question: A patient came for a consultation. The next week the patient came back to furt... Read more
You Be the Coder:
Neupogen
Question: We are a hospital-outpatient department (medical oncology). What is the proper w... Read more
Optimize Pay Up for Prostate Cancer Treatment
When New York City Mayor Rudolph Giuliani announced that he had prostate cancer at the end... Read more
Be Rightfully Reimbursed for Pain Management
Pain management has garnered increased attention recently. End-of-life care advocates have... Read more
Fewer Denials With the New Medical-necessity Definition
A new definition of medical necessity, one that doesnt include the words experimental or ... Read more
HCFA Announces New ICD-9 Codes
In an attempt to keep up with new technologies and the ever-changing face of medicine, the... Read more
News Brief:
Draft Guidance Issued for Small-practice Compliance Programs
The department of Health and Human Services Office of Inspector General issued draft guida... Read more
Reader Question:
Observation by Admitting Physician or Consultant
Question: An independent oncology physician is seeing patients who have been admitted to t... Read more
Reader Question:
Who Gets Paid for Cancer Treatment?
Question: Several of us have offices on the same floor as our hospitals cancer treatment c... Read more
You Be the Coder:
Bone Marrow Biopsies
Test your coding knowledge. Determine how you would code this situation before looking at... Read more
Boost Reimbursement for Infusion-pump Use
Oncology practices that have been billing for both chemotherapy administration and the use... Read more
Promote Coding Accuracy With Internal Chart Audits
In the day-in-day-out battle to stay compliant with reimbursement regulations, oncology p... Read more
Boost Reimbursement by Understanding APC Coverage
Hospital-based radiation oncologists dont have the same luxury of time their medical oncol... Read more
Redare Question:
Epidermoid Carcinoma of the Lip
Question: How do you code epidermoid carcinoma of the lip, with wide excision of the lesio... Read more
Reader Question:
Infusion Pump Billing
Question: Can you tell me how to bill for the use of infusion pumps to administer chemothe... Read more
You Be the Coder:
Lung Cancer Treatment
Test your coding knowledge. Determine how you would code this situation before looking at... Read more
Dont Be Denied Reimbursement for Appropriate Off-label Chemotherapy Use
You may have put several patients through a chemotherapy regimen using a drug (Taxol, for ... Read more
Maximize Reimbursement for Incident-to Billing
Oncology practices that have their physician assistants and nurse practitioners bill Medi... Read more
Use Prolonged-service Codes Correctly to Avoid Audits
Making rounds through a chemotherapy area to answer patients questions and to address the... Read more
Update:
Following AHIMAs Standards Promotes Coding Excellence
Proper coding for oncology procedures and practices requires up-to-the-minute information,... Read more
Reader Question:
Cancer Consultation
Test your coding knowledge. Determine how you would code this situation before looking at... Read more
Reader Question:
T-cells
Question: I have a patient who had a transfusion of T-cells from a donor. I have done some... Read more
Reader Question:
Sodium Chloride
Question: Please discuss the difference among 0.9 percent sodium chloride in 20ml vials, 2... Read more
Determine Decision-making Complexity Correctly for Maximum Pay Up
To ensure your evaluation and management (E/M) service charges are safe from auditor scrut... Read more
Documenting Medical Decision-making
Using a scoring system is an effective way to reduce the subjectivity of determining the c... Read more
Use CPO Codes to Gain Proper Reimbursement
Log systems that track the time physicians spend on care plan oversight (CPO) provided to ... Read more
More About Antiemetics
In the March 2000 Oncology Coding Alert, Reader Questions, a reader asked about coding for... Read more
Reader Question:
Navelbine
Question: For a drug called Navelbine (J9390) that needs to be "pushed" through an intrave... Read more
Reader Question:
Dosimetry
Question: Are there clear-cut rules established as to how many of code 77300 (basic radi... Read more
You Be the Coder:
Zoladex
Test your coding knowledge. Determine how you would code this situation before looking at... Read more
How to Meet the New E/M Exam Coding Requirements and Maximize Reimbursement
Oncology physicians that usually jot down phrases such as normal, negative, and no problem... Read more
Prolonged Services:
Using Modifier -21 May Be More Accurate Than Add-on Codes
Billing for evaluation and management (E/M) services often is challenging. In cases where ... Read more
How to Get Paid for Same-group Consults
From time to time there is uncertainty over whether a patient encounter is a consult or an... Read more
Reader Question:
Administering Epoetin Alpha
Question: In the December 1999 issue of Oncology Coding Alert, the Correctly Code Epoetin-... Read more
Reader Question:
Antiemetics
Question: We have had Medicare denials for using Anzemet (dolasetron) as an intravenous pr... Read more
You Be the Coder:
Chemotherapy Administration
Test your coding knowledge. Determine how you would code this situation before looking at... Read more
Bill Supportive Care Drugs Separately From Chemotherapy to Optimize Reimbursement
With the host of drugs that accompany chemotherapy, it is often expedient to lump such dru... Read more
Correctly Code for Oral Chemotherapy
To bill correctly and get reimbursed for oral anti-cancer drugs and prodrugs, claims shoul... Read more
Detailed Questioning Key To Correctly Coding for E/M
Detailed questioning is crucial to correctly coding for evaluation and management (E/M) se... Read more
Coding in the News:
Thyroid Lobectomy
Recent News Item: In the last days of 1999, Tipper Gore, the wife of Vice President Al Gor... Read more
Reader Question:
Consult vs. New Patient
Question: Do you bill a patients first office visit with an oncologist as a consult or new... Read more
You Be the Coder:
Billing for Unused Drugs
Test your coding knowledge. Determine how you would code this situation before looking at... Read more
How to Differentiate Between the Levels of Treatment Planning
Planning treatment for patients set to undergo radiation therapy is a complex task, but de... Read more
You Be theCoder:
Chemotherapy Administration
Test your coding knowledge. Determine how you would code this situation before looking at... Read more
Avoid Unbundling Scenario In Gynecological Oncology Procedures
Gynecological oncologists can avoid the unbundling trap when assisting gynecologists with... Read more
Five Tips for Maximizing Payup During Initial Cancer Diagnosis Appointment
Newly diagnosed patients require considerable resources from oncology practices in the for... Read more
Reader Question:
Administering Epoetin-alfa
Question: One of our readers challenged us to review our December advice again on the prop... Read more
Available Years:  2000  1999