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Oncology & Hematology Coding Alert

Reporting J1567 for IVIG? Not Anymore
Learn the new Q codes -- or risk losing more than $30 for each dose If you haven't up... Read more
News You Can Use:
Keep an Eye on E/M to Avoid CERT Attention
Surprise: Medicare found some oncologists undercoding Errors in billing, coding and d... Read more
Possible 9.9 Percent CMS Payment Cut
Oncologists escape more severe cuts -- but some colleagues won't be so lucky If the p... Read more
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Keep Your Drug Supply J Codes Handy
Having trouble telling biologic response modifiers from monoclonal antibodies? Our chart... Read more
Reader Question:
Bank on These 77427 Do's and Don'ts
Question: What services does 77427 include? North Dakota Subscriber Answer: You shou... Read more
Reader Question:
Locum Tenens Solutions in 3 Steps
Question: One of our oncologists will be out of the office for an extended period, and a... Read more
Reader Question:
Develop Proper Port Film Coding
Question: I know we can only bill one port film per week of treatment management regardl... Read more
Reader Question:
Avoid the Level-3 E/M Rut
Question: I think my oncologists frequently perform established patient office visits th... Read more
You Be the Coder:
Find Suitable Fletcher-Suit Code
Question: How would a radiation oncologist code for a Fletcher-Suit ovoid radiation devi... Read more
Unravel the Secret of Accurate Intracavitary Brachytherapy Coding
See beam radiation treatment, too? Stop leaving reimbursement on the table You-ve got... Read more
News You Can Use:
Red Flag - CMS Adds New Brachytherapy Facility Codes
Master reporting strand units from the get-goIf you-re preparing to send out a claim repor... Read more
Back to Basics:
Pave the Way to ICD-9 Expertise With 3 Essential Tips
You need to pay special attention to this V code rule You can cut out a good chunk of ... Read more
Reader Questions:
Gender Matters for Breast Code
Question: What code should I report for a male patient with a malignant tumor in the upper... Read more
Reader Questions:
Check CPT for Dressing Change Code
Question: What code should I report for a male patient with a malignant tumor in the upper... Read more
Reader Questions:
Read Drug Label Before Coding Units
Question: If we have to waste part of a single-use drug vial, how should I calculate the u... Read more
Reader Questions:
Lap Up These 141.x Tips
Question: What terms should I look for to be sure I choose the most appropriate code from ... Read more
Reader Questions:
Keep Pterygium Planning Simple
Question: Which treatment planning code should I report when the radiation oncologist uses... Read more
You Be the Coder:
Pick Proper Remission Code
Question: I-m having trouble finding a -history of- code to describe plasma cell leukemia ... Read more
Perfect Your Intra-Arterial Claims With This 96420-96425 Primer
Don't own the pump? That doesn't mean you have to miss out on 96425 reimbursement Liv... Read more
Apply This Prolonged Services Rule or Risk Losing $90
Hint: Make sure you meet this minimum time requirement first CPT offers you the chance ... Read more
Time-Based E/M? Take Care With Prolonged Services
Don't miss when modifier 21 belongs on your claim instead Confused about the exceptio... Read more
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Find PQRI Category II Codes at a Glance
Read modifier descriptors carefully -- details count Last month, Oncology Coding Aler... Read more
Reader Questions:
Concurrent Push Isn't Equal to Concurrent Infusion
Question: Which CPT codes should I use for the following report? I-m confused about whic... Read more
Reader Questions:
Clear up Same-Specialty MD Consult Rule
Question: May I code a consult when oncologist A requests a consult from oncologist B? ... Read more
Reader Questions:
Meet 77370 Documentation Requirements
Question: I-m coding a physics consultation for a pregnant patient undergoing radiation.... Read more
You Be the Coder:
Code This Hydration/Chemo Combo
Question: What codes should I report when a patient comes in for a cisplatin infusion, a... Read more
Master Prostate Brachytherapy Coding and Escape the Seed-vs.-Marker Trap
Take in this expert tip before you add 55875 to another oncology claim The radiation on... Read more
Category III Update:
Post These Brachytherapy Guidelines Front and Center
You may not be able to count on CCI software to keep you in the clear A glance through ... Read more
Navigate Your Way Around 2 E/M Pitfalls With This Analysis
Don't miss the simple action that will keep you clear of pitfall 2 A little E/M infor... Read more
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Keep These PQRI G Codes Close to Save Time
Make getting the 1.5 percent bonus as easy as possible If your practice is participat... Read more
Reader Questions:
Apply This IVIG Change July 1
Question: I-ve been reporting J1567 for immune globulin. Is this correct for Medicare? ... Read more
Reader Questions:
Guard Against Incorrect 77334 Use
Question: Should I report 77334 for a head and neck cancer patient's mouth guard? South... Read more
Reader Questions:
Memorize 'Separate Session/Site/Procedure' for 59
Question: I know I don't need separate diagnoses for separate procedures I report with m... Read more
Reader Questions:
Pair Zometa With J3487
Question: I recently started working at a multispecialty practice that administers zoled... Read more
You Be the Coder:
Don't Get Start/Stop Time Stumped
Question: How should I code a report that shows an intravenous chemotherapy infusion sta... Read more
Simplify Your Work ~ Shatter These 5 'Push' Myths to Create Pristine Claims
Steer clear of this common concurrent coding misdeed Reporting push codes often requires ... Read more
Secure the Correct E/M History Level -- Every Time
Auditors are watching, but these tips keep you in the clear If choosing E/M patient histo... Read more
Guide to Systems
The CPT manual E/M Guidelines list 14 different systems the provider may review:- constitu... Read more
Reader Question ~ Grasp When Lowest or Highest Element Drives E/M
Question: What do E/M codes mean when they say you only need two of three components?Texas... Read more
Reader Question ~ Avoid This Hydration Coding Hiccup
Question: May I report a hydration code when a physician administers Phenergan and a 250-c... Read more
Reader Question ~ Focus on 184.0 for Vaginal Cancer
Question: Which ICD-9 codes are appropriate for vaginal carcinoma?West Virginia Subscriber... Read more
Reader Question ~ Read Full V10 Rule
Question: I heard that if a primary malignancy has been excised, I-m supposed to report a ... Read more
Reader Question ~ Dry Up Amifostine Confusion
Question: Which diagnosis codes prove medical necessity for amifostine for a lip cancer ... Read more
You Be the Coder ~ Match Zevalin to Monoclonal Antibody Code?
Question: When the oncologist uses Zevalin as monoclonal antibody therapy, should I report... Read more
Tackle the Top-3 ICD-9 Oncology Changes Before the Oct. 1 Deadline Hits
 Tried-and-true tactics get your doctor's documentation on board with these more spec... Read more
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Size Up ICD-9 2008 Oncology Codes at a Glance
 Red alert: Grace periods are in the past -- prep now for the Oct. 1 deadline Oncolo... Read more
Quiz:
Try Your Skills Across the Oncology Coding Spectrum
 Discover where your strengths lie with these 5 questions Oncology coding requires y... Read more
Quiz Answers:
Try Your Skills Across the Oncology Coding Spectrum
How did you do? Find out below.  1. Procedure status: Status A means -Active code.- ... Read more
Clarification
“Steer Clear of This Tempting IMRT Coding Trap,” in the April 2007 issue, re... Read more
Reader Questions:
Catch Up on Latest Clinical Trial Changes
Question: What diagnosis codes should I report for a Medicare patient in a qualifying diag... Read more
Reader Questions:
Aim to Use NPI ASAP
Question: I-m confused about the NPI deadlines. Is there a decision about when we must use... Read more
Reader Questions:
Nix Treatment Plan Code for Nuclear Medicine
Question: Should I report a clinical treatment plan code for a strontium injection?Washing... Read more
Reader Questions:
Watch Bundle With Ommaya Admin
Question: Can we code fluid aspiration for testing when we administer methotrexate through... Read more
Reader Questions:
Forget FB When Hospital Supplies Drug
Question: We recently received a provider claim communication saying the modifier we used ... Read more
You Be the Coder:
Will You Avoid This Infusion Pitfall?
 Question: What CPT infusion codes should I report for a 150-minute Rituximab infusio... Read more
Follow This Map to Ultimate Hodgkin's ICD-9 Specificity
Watch out: 1 common coding tool could be costing you time and money  Finding the rig... Read more
Pick Up on When Encounter Code Is Primary
When the sole purpose of the patient's visit is radiotherapy or chemotherapy, sequence the... Read more
Back to Basics:
Add to Your Bottom Line With These Add-On Code Essentials
Try this strategy to get full ethical reimbursement from payers If you don't think -add-o... Read more
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Speed Up Learning Add-On Rules With This Tool
6 tips make you the master of these specially designated codes Although CPT's -add-on- de... Read more
Begin This PQRI Plan by July 1 or Risk Missing the Bonus
1 pointer helps you meet the requirements for the 1.5 percent boost  You-ve heard th... Read more
Reader Questions:
Expect Calcitonin Denial
Question: I-ve been getting denials from Medicare for calcitonin injections provided incid... Read more
Reader Questions:
Match 32 to Mandated Service
Question: When should I use modifier 32?California Subscriber  Answer: You should ap... Read more
Reader Questions:
Check Coverage Rules for Surprise EPO Change
Question: We-re having a dispute in our office regarding how to code EPO for cancer patien... Read more
Reader Questions:
Head Off 'History of' Troubles
Question: To use a -history of- neoplasm diagnosis code, how many years does the patient n... Read more
Reader Questions:
Look to 197.7 for Metastasis to Liver
Question: What diagnosis codes should I report for a patient with small cell carcinoma of ... Read more
You Be the Coder:
Don't Trip Over Treatment Fractions
Question: What CPT and ICD-9 codes should I report for management of eight treatment fract... Read more
Act Now to Grab This $600 SRS Reimbursement Boost
A 77435 bundling change lets your physician get paid for his work If your freestandin... Read more
Discover NCCI 13.1 Oncology Changes at a Glance
Keep these injection codes off of your chemo admin claims National Correct Coding Ini... Read more
Payer Corner:
Start Your UHC Imaging Accreditation Process Today
Next spring will be too late American College of Radiology accreditation isn't just f... Read more
Pinpoint the 1 Spot Where Modifier 25 Belongs on a Claim
But read this OIG report before you fill in the blanks Deciding which codes and modif... Read more
News You Can Use:
Add This Neoplasm Dx to Your Covered Codes List
Plus: A new ABN is in the works CMS is busy making changes that affect your reimburse... Read more
Are You Using a Compliant CMS-1500 Form?
Are You Using a Compliant CMS-1500 Form? Warning: CMS revealed that the Government Pr... Read more
Reader Questions:
Know Whether Payer or NCCI Is Stricter
Question: The March issue of Oncology Coding Alert included a list of National Correct... Read more
Reader Questions:
Crack Down on Critical Care Code Mistakes
Question: Are there E/M codes I shouldn't report alongside prolonged services codes 99... Read more
Reader Questions:
No Peritoneocentesis? Try 96445-52
Question: What CPT code should I use for chemo administration into the peritoneal cavi... Read more
Reader Questions:
Code Chemo by Intended Service, Not Time
Question: Our patient was supposed to receive a Taxol infusion, but after five minutes... Read more
Reader Questions:
Absorb Costs of Correcting Medical Error
Question: Our clinic accidentally gave a patient an excessive amount of a prescribed d... Read more
Reader Questions:
Hunt Down Hepatitis Exposure Code
Question: How should I code exposure to viral hepatitis? Oregon Subscriber Answer:... Read more
Reader Questions:
Pause Before Coding Stopped Procedure
Question: We recently had a situation in which the oncologist decided not to perform r... Read more
Reader Questions:
Get Specifics of Tumor Lysis Syndrome
Question: Is there a code for tumor lysis syndrome? I can't find one anywhere. Georgi... Read more
Reader Questions:
Stop Cheating Yourself of SNF Payment
Question: When we provide radiation therapy to a patient in a SNF unit, should we bill... Read more
You Be the Coder:
Rate Your Radiopharmaceutical Skills
Question: What CPT and ICD-9 codes should I report for a patient with a primary prosta... Read more
Steer Clear of This Tempting IMRT Coding Trap
Reporting IMRT as conformal treatment for coverage will land you in hot waterTracking paye... Read more
Quiz:
Assess Your E/M Skills in a Flash
Determine whether you-ve grasped the subtleties of this tricky code setReporting E/M codes... Read more
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Stop Wasting Time Searching for Status Indicator Definitions
Try this easy-access chart CMS uses lots of symbols and abbreviations in its physician fe... Read more
Reader Question:
Forget About 99363 Payment From CMS
Question: I-ve had no luck getting paid for the new Coumadin management codes. Am I missin... Read more
Reader Question:
Keep Away From Consult Code for Second Opinion
Question: Which CPT code should we report when a patient comes to our oncologist for a sec... Read more
Reader Question:
Don't Sweat Dehydration Coding
Question: When a patient presents for treatment of dehydration caused by therapy, should I... Read more
Reader Question:
Watch This OIG/Bone Marrow Hot Spot
Question: How should I code a bone marrow biopsy with aspiration?Illinois SubscriberAnswer... Read more
Reader Question:
Try This New vs. Established Decision Tree
Question: I have trouble keeping up with the little rules about whether a patient is new o... Read more
You Be the Coder:
Demystify Declotting Code
Question: Can I report 36550 for declotting a catheter using Activase after nurses couldn'... Read more
Dodge This Disastrous IMRT Planning Pitfall
What's your payer's rule on 77301 and forward planning? A lot of work goes into planning ... Read more
Take Action Against These Common 77301 Claim Killers
Applying these NCCI edits is a must for clean IMRT plan claims Col. 1  - IMRT T... Read more
Size Up Your ICD-9 Skills With This Cancer Diagnosis Tale
Hint: You may need to flip to the V code section of the manual Did you ever tell someone ... Read more
NEWS YOU CAN USE ~ Make Sure Patients Know the BBBD Chemo Coverage Score
CMS doesn't want to foot this $500,000 billIt looks as if CMS is going to make the ban on ... Read more
CORRECTION
“You Be the Coder: Report Post-Chemo Nausea Med Separately” in the February ... Read more
READER QUESTION ~ Prevent Denials for Prophylactic Treatment
Question: I-m new to oncology coding and am having trouble coding a report involving radia... Read more
READER QUESTION ~ Check PVRP for Demo Codes
Question: What's the word on whether the 2006 demonstration project will continue?Iowa Sub... Read more
READER QUESTION ~ Apply 96040 for Genetic Counselor Services Only
Question: We-re considering hiring a genetic counselor. What should I know about coding fo... Read more
READER QUESTION ~ Keep Consult Request Forms for True Consults
Question: We are a small medical oncology practice and we sometimes refer patients to anot... Read more
READER QUESTION ~ Append 59 Based on Column 1/Column 2
Question: Should I always append modifier 59 to the lower-valued code of an NCCI edit pair... Read more
YOU BE THE CODER ~ Remember All Codes on IVIG Days
Question: How should I code for pre-admin services for IVIG?Washington, D.C., SubscriberAn... Read more
Stop HCPCS Denials in Their Tracks With This Comprehensive Review of 2007's New Codes
Don't cheat yourself by underreporting units If you code for the drugs you supply to pati... Read more
Infuse Your Coding With Crucial 90765-90768 Skills
Use this quiz to determine where to focus your infusion coding education You-ve had a yea... Read more
Protect Yourself:
CMS Zeroes In on Infusions Over 8 Hours
Keep in mind these 2007 changes for drug admin If you can't remember which codes you can ... Read more
Think of New MUEs as a Way to Avoid Repayment
Starting Jan. 1, these CMS edits hunt down unit mistakes All-new -Medically Unlikely ... Read more
Take One Last Look to Be Sure Your NPI Ducks Are in a Row
See whether your software vendor is as on the ball as you are You may be numb to NPI news... Read more
NEWS YOU CAN USE ~ Continue to Watch Guidance Code Claims, NCCI Says
Don't worry -- 13.0 isn't too unlucky for oncology National Correct Coding Initiativ... Read more
READER QUESTION ~ Sum Up Stromal ICD-9 Changes
Question: I-m having trouble keeping track of the ICD-9 changes to coding stromal neoplasm... Read more
READER QUESTION ~ Keep Track of Chronic Condition Documentation
Question: The 1997 audit guidelines state that I can reach an extended history by updating... Read more
READER QUESTION ~ Revert to 82270 for FOBT
Question: I-m a coder for a multispecialty clinic that performs fecal-occult blood tests (... Read more
READER QUESTION ~ Audit Your Charts Before Authorities Do
Question: Do you have any tips for performing a coding self-audit? Mississippi Subscriber ... Read more
READER QUESTION ~ Don't Assume Mass = Neoplasm
Question: When the oncologist documents a -renal mass,- is this the same as a neoplasm?Ore... Read more
YOU BE THE CODER ~ Report Post-Chemo Nausea Med?
Question: When Medicare patients receive an intravenous dose of ondansetron after a chemot... Read more
ICD-9 UPDATE ~ Make Room for V86.x on Breast Neoplasm Claims, Official Guidelines Say
Plus: See what the guidelines say about your SIRS reports The latest CMS-approved ICD-9 O... Read more
Master CMS' Rule on Modifier 25 and Global Periods
Hint: -000- and no global aren't the same thing If you-re confused by CMS- 2006 clarifica... Read more
CPT UPDATE ~ Don't Miss the New Codes for Coumadin Management
Count INR measurements to ensure coding accuracy You-ll have two new codes to report anti... Read more
NPI ~ Are You Referencing the Right CMS-1500 Instructions?
Be sure you-ve got revised MLN article MM5060 You don't want to miss this revision t... Read more
NEWS YOU CAN USE ~ Nope -- That 26 Percent PET Pay Cut Is Not a Typo
HOPPS rates deal a blow to oncology PET studies The final Hospital Outpatient Prospective... Read more
READER QUESTION ~ Check Payer Supervision Rules on 99211
Question: If a patient pays for her medicine and goes to the clinic for the nurse to give ... Read more
READER QUESTION ~ Expect OIG Input on Imaging and IVIG
Question: What's in the OIG's 2007 Work Plan that will effect oncology practices?North Car... Read more
READER QUESTION ~ Let Guidelines Steer 'Hx of' Coding
Question: Would you explain when it is appropriate to Question: Would you explain when it ... Read more
YOU BE THE CODER ~ Decide Which Dx Matches Your EKG
Question: Our practice sometimes performs EKGs on patients taking chemo drugs that can aff... Read more
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