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Oncology & Hematology Coding Alert

Prevent Drug Waste From Shrinking Your Bottom Line -- Here's How
Master the difference between single- and multiuse vials Chemotherapy drugs are expensi... Read more
You Can't Bill Preventable Drug Waste
If drug waste occurs because your provider did not evaluate the patient sufficiently prior... Read more
Third-Party Payers May Differ
Many payers want you to include the amount of drug used and the amount of drug wasted as a... Read more
Claim Every Billable Consult and Boost Your Bottom Line
You can still report a consult if your physician begins treatment Coders across all spe... Read more
New Code Sneak Peek:
Look Out for 3D Positional Tracking Code
What's in store for 0197T payment? The AMA recently released limited, early information... Read more
Reader Questions:
History Begins When Active Treatment Ends
Question: If a patient has been diagnosed with cancer, does a "history of cancer" diagno... Read more
Reader Questions:
Count Minutes Carefully for Chemo Infusion
Question: What's my coding for a patient with primary neoplasm of the rectosigmoid junct... Read more
Reader Questions:
Stick With 183 for Ovarian Cancer
Question: Which is the appropriate ICD-9 code for micropapillary ovarian cancer? Delawa... Read more
Reader Questions:
ID Underlying Cancer as Primary With SIRS Dx
Question: If the oncologist documents SIRS due to cancer, what is the appropriate diagno... Read more
You Be the Coder:
Is 77301 'Once and Done?'
Question: May I report multiple units of 77301 if the treatment plan covers several targ... Read more
Ace Neoplasm Diagnoses in Just 4 Steps
Wait for the pathology report and carefully review ICD-9 tables for claims success If y... Read more
Radiation Focus:
Capture All the $$ You Deserve for Prostate Brachytherapy
Number of sources determines several coding choices Last issue, we discussed coding for... Read more
Reader Questions:
Pick Proper Pernicious Anemia Code
Question: Which codes should I report when a patient with pernicious anemia presents for... Read more
Reader Questions:
Crack 0182T's PC/TC Code
Question: Is 0182T a technical component-only code? Massachusetts Subscriber Answer:... Read more
Reader Questions:
Watch POS When Reporting Q3001
Question: Can our office receive compensation for supplying brachytherapy prostate seeds... Read more
Reader Questions:
Note Subspecialty Rule for Second Opinion
Question: We-ve seen a lot of "self-referred" patients lately. Should I report these as ... Read more
Reader Questions:
Don't Miss Medicare Rule on 77416 x 2
Question: How should I report two 20 MeV radiation treatments on the same day if we trea... Read more
Reader Questions:
Count on These PQRI Resources
Question: We are trying to code for the Physician Quality Reporting Initiative (PQRI), b... Read more
You Be the Coder:
How Should You Report Filgrastim Injections?
Question: Should I report 96401 or 90772 for Neulasta and Neupogen injections? Missouri... Read more
Pump Up Payments With Optimum Prolonged IV Administration Coding
Call on modifier KD to recoup drug costs When coding for prolonged drug infusion via a po... Read more
Watch for Pain Pump, IV Infusion Combination
In some cases, the patient may receive an IV infusion and prolonged infusion initiation on... Read more
Radiation Oncology Focus:
Stay Flexible to Clinch Prostate Brachytherapy Coding
Capture an extra $50 for oncologist-performed volume and mapping Applying a -one-size-fit... Read more
CCI Update:
Version 14.2 Halts Payment of 90769 With Several E/M Codes
Version 14.2 of the national Correct Coding Initiative (CCI) now bundles 90769 (Subcutaneo... Read more
Reader Questions:
Stick to 77432 for Oncologist's Role
Question: Which codes should I report for gamma knife treatment? I bill for an oncologist ... Read more
Reader Questions:
Additional Service? Don't Report 96523
Question: I-ve heard the rule that I should report a port flush if it's the only service r... Read more
Reader Questions:
AMA Says 77417 x 1 for Multiple Ports
Question: The AMA and my local carrier give conflicting information regarding port films. ... Read more
Reader Questions:
Plan Ahead for Split Chemo Claim
Question: Our practice received a denial for 96417 with 96413 and 96415 for Vectibix and C... Read more
Reader Questions:
Don't Claim Discarded Herceptin
Question: We-re having a dispute in our office about reporting Herceptin. Should I report ... Read more
You Be the Coder:
Meet Bone Marrow Coding Rules
Question: At our center, we perform bone marrow aspiration and biopsies, and also perform ... Read more
Get Your 2009 ICD-9 Coding Down Pat to Avoid 209.xx Tumor Errors
We walk you through these can-t-live-without changes Now is definitely the time to prep... Read more
Money in the Bank:
Earn More Than $900 per Brachytherapy Procedure
Keep these HDR descriptors straight to guarantee solid claims every time Keeping track ... Read more
Ask the Expert:
Don't Risk Losing Phlebotomy Dollars Through Miscoding
Let our guru teach you how to net almost $60 per 99195 procedure You know that there is... Read more
Reader Questions:
Learn Foolproof Drug Wastage Calculation
Question: When we code for drug wastage, I-m always concerned we-ll make an error. I hav... Read more
Reader Questions:
Pay Attention to All Consult Requirements
Question: Patients are visiting our oncology center specifically for consultations, not ... Read more
Reader Questions:
Use Caution When Coding for Renal Mass
Question: Our oncologist documented a "renal mass," and I-m not sure how to code correct... Read more
Reader Questions:
Look Out for New Octagam J Code
Question: We are treating a Medicare patient who is in replacement therapy for hemophago... Read more
You Be the Coder:
Which Comes First, Dehydration or Neoplasm?
Question: We had a patient present with dehydration following therapy on a previous day ... Read more
Take Your Leukemia Diagnosis Coding to Even Higher Levels -- Here's How
Expect denials if you miss this fifth-digit relapse change ICD-9 2009 brings a truckloa... Read more
Expect Changes for Code 999 in 2009
This chemotherapy complication gets the spotlight You can look forward to something new... Read more
Hit the HIT Jackpot With Fall's New Options
Thrombocytopenia coding made easier You can expect fresh help coding for heparin-induce... Read more
Coding Challenge:
Hone Your ICD-9 and CPT Skills With Our Cancer Quiz
Heads-up: V codes are fair game Because you work in an oncology office, you-ve probably... Read more
Answers to the ICD-9 and CPT Cancer Quiz
1. 172.3 (Malignant melanoma of skin; other and unspecified parts of face). The ICD-9 man... Read more
Reader Questions:
Code for Merkel Cell Tumor Using 173.X
Question: A patient has been diagnosed with a Merkel cell tumor on the skin of his leg. ... Read more
Reader Questions:
Round Up When Coding 75-mg Arranon Dose
Question: Our oncologist is treating a patient with T-cell lymphoblastic lymphoma. The p... Read more
Reader Questions:
Count Refills in E/M Time
Question: Can we bill an insurance carrier for a prescription refill, especially for pat... Read more
Reader Questions:
Be Careful When Reporting Patient-Purchased Drugs
Question: If one of our Medicare patients purchases a drug and our NPP administers it, m... Read more
Reader Questions:
Figure Face-to-Face Time for This Consult
Question: A patient came to the office to see the oncologist, and the patient refused to... Read more
You Be the Coder:
OK to Report Saline With Drug Administration?
Question: One of the nonphysician practitioners on staff was treating a patient who had ... Read more
Start Raking in Your Rightful Radiosurgery Dollars, Says CCI 14.1
Learn how these deleted edits can earn you up to $177 more Hold on to your c... Read more
Medicare Offers Great News for Anti-Emetic Reimbursement
These changes -- and ESA updates -- may change your coding habits Spring is here, bring... Read more
Eliminate E/M Upcoding to Avoid Undue Audit Attention
Are your claims sending up the most hazardous -red flags-? Medicare paid oncology and h... Read more
Look Out for ICD-9 Changes:
2009 Is Closer Than You Think
Here's a first look at new hematology, oncology codes that will affect you Fever coding... Read more
Reader Questions:
Prevent Denials for Infusions
Question: We have quite a few 90766 denials stating that the "qualifying service was not... Read more
Reader Questions:
Don't Overuse Add-Ons for Multiple Procedures
Question: During a recent visit, one of our staff members administered multiple therapeu... Read more
Reader Questions:
Single Unit of 77301 Is Best Choice for IMRT
Question: Our oncologist is treating multiple targets in a single anatomic site using IM... Read more
Reader Questions:
ABN Supersedes NEMB Form Soon
Question: I have heard that the new advance beneficiary notice makes the notice of exclu... Read more
Reader Questions:
9 Digits May Zip Up Reimbursement
Question: We are getting denials from Medicare saying they can't see box 32 in our claim... Read more
Reader Questions:
Count Refills in E/M Time
Question: May we bill an insurance carrier for a prescription refill, especially for pat... Read more
Reader Questions:
Watch Setting for Hydration Code
Question: A physician at our hospital ordered intravenous hydration for a pediatric pati... Read more
You Be the Coder:
Consider Chemotherapy Coding Carefully
Question: A physician at our clinic is treating a patient for liver cancer and ordered a... Read more
Don't Let $75,000 in Pemetrexed Payment Slip Through Your Fingers -- Here's How
We bust drug claim errors that can steal your rightful dollars You could be losing as ... Read more
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Recognize the Codes for Your Top-10 Underbilled Drugs
Hang on to this handy chart of the drugs you can't afford to leave off claims The next ... Read more
Don't Chance Billing Your E/M Claims Incorrectly
Neoplasm and fatigue could mean higher MDM There's no time like the present to hone you... Read more
2008 PQRI, Part 2:
Boost Your Prostate Cancer Reporting Accuracy
We further detail the measures that will have the most effect on you We continue our se... Read more
Reader Questions:
Charge for Second IMRT Plan, CT Sometimes
Question: If a patient requires a second intensity modulated radiation therapy plan, may... Read more
Reader Questions:
Overnight Hydration Infusion Pump Is Unlisted
Question: We put patients on an ambulatory infusion pump with normal saline for overnigh... Read more
Reader Questions:
No New 2008 Code for Port Flush
Question: Is there a new 2008 code that we can use when our hematologist orders peripher... Read more
Reader Questions:
New Q0, Q1 Modifiers Help Clarify Routine Services
Question: When am I supposed to start using the new NOPR modifiers? Maryland Subscriber... Read more
Reader Questions:
No OV Code Needed for Infusion Treatments
Question: I have heard that I should charge every infusion patient for a patient visit o... Read more
You Be the Coder:
Same-Day Billing for Port Flush?
Question: If a patient sees an oncologist who performs an established patient visit (992... Read more
5 Tips Take Your ESA Coding Up a Notch
Missing these new HGB and HCT coding policies could sink your claims When your practice... Read more
On the Cutting Edge:
Make the 2008 PQRI Work for You With These Expert Insights
Master the necessary modifiers to avoid losing out on reimbursement The Physician Quali... Read more
We Bring You the 2008 PQRI in a Nutshell
Focus on the new measures that will affect you most You-ll find a handy new 2008 PQRI c... Read more
Reader Questions:
Be Careful Coding for Same Day, Same Specialty
Question: A lung cancer patient came to the practice in the morning, and Oncologist A fo... Read more
Reader Questions:
No Single-Code Multiple-Line-Item Reimbursement
Question: Is there a limitation to how many times I can bill 90772 per visit? Our office... Read more
Reader Questions:
Modifiers Not Necessary With 96415
Question: How should I code for a four-hour chemo? Should I put modifier 59 (Distinct pr... Read more
You Be the Coder:
Solve the Ixempra Coding Conundrum
Question: Does HCPCS offer a specific J Code for Ixempra yet? Colorado Subscriber Answ... Read more
CCI 14.0:
Apply a Host of New Needle Placement Procedure Bundles
Also: Venipuncture and intracatheter introduction become part of more than 75 codes intr... Read more
Don't Freeze Up Over Fewer Cryopreservation Choices
CCI deletions highlight G-code ouster You won't have G0265 and G0266 to kick around any... Read more
News You Can Use:
Doctors Get Happy New Year With 0.5 Percent Pay Raise
But the rule only extends until June 30, so you-ll still need another fix mid-year If y... Read more
Reporting Q4087 for IVIG? Not Anymore
New MLN Matters article reminds coders to ditch 2007's mid-year replacement codes Myth:... Read more
Reader Questions:
Use Modifier GD With Caution
Question: If our clinic can show medical necessity for multiple units of a single proced... Read more
Reader Questions:
Prepare for 'UHC Meets CCI'
Question: I-ve heard that I-m going to have to start changing some of the codes that I b... Read more
Reader Questions:
Include PICC Removal in E/M
Question: Is there a code for pulling/removing a PICC line in the office? This is not a ... Read more
Reader Questions:
New Doctor May Bring Established Patients
Question: We have a new oncologist who is coming over from a nearby county, so of course... Read more
Reader Questions:
Complete ROS Requires Double-Digit Reviews
Question: What is the difference between problem-pertinent, extended and complete review... Read more
Reader Questions:
Choosing Initial Infusion Type
Question: A patient presents for chemotherapy treatment. The oncologist performs a 30-mi... Read more
You Be the Coder:
Blood Draw and Port Flush
Question: If a patient sees the physician and the physician bills for a blood draw and t... Read more
Master This Therapeutic Phlebotomy Coding Conundrum
Confuse phlebotomy with blood draws, and risk losing $57 each time Therapeutic phleboto... Read more
News You Can Use:
Medicare Hangs Up on Phone, Online E/M
CMS is pro high-tech -- except when it comes to evaluation and management Don't get too... Read more
Watch for These Clues to Use 36415, 8500x for In-House CBC
Be sure to code only 1 collection fee per patient Once you-ve determined that a blood d... Read more
Reader Questions:
77301 Describes IMRT Planning
Question: How should I report IMRT treatment planning and delivery for a head and neck c... Read more
Reader Questions:
Mirror Port Doesn't Merit Extra Unit
Question: May I report 77300 more than once per port? Maine Subscriber Answer: Payer... Read more
Reader Questions:
Document All Activities During CPO Service
Question: When the oncologist performs monthly care plan oversight (CPO) for a Medicare ... Read more
Reader Questions:
Find New ABN Forms on the CMS Web Site
Question: I-ve read that there's a new ABN form, but I can't find it anywhere. Where sho... Read more
Reader Questions:
Fixate on This Correct Modifier 59 Placement
Question: When we-re following Correct Coding Initiative (CCI) edits, which code should ... Read more
Reader Questions:
Keep PHI Out of Outsiders' Inboxes
Question: I sometimes e-mail patient records to consultants or other coders for help on ... Read more
You Be the Coder:
Understand HDR Division of Labor
Question: Our hospital will begin to do HDR soon. What code should I report for a radiat... Read more
Coding 284.8 for Anemia Secondary to Chemo? Read This First
Also: Get ready to fight for ESA coverage Finding the right diagnosis code for patients... Read more
Keep Track of Coverage Conditions for ESAs
If Medicare's national determination stands, your billing options may be limited Oncolo... Read more
News You Can Use:
Watch Guidelines for Moderate Sedation Pay to Reap Rewards
You-re not dreaming: You may soon see reimbursement for 99143-99145 When your oncology ... Read more
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Find New HCPCS Codes Fast With This Handy Chart
Heads up: Your IVIG codes are changing -- again In July, oncology coders needed to upda... Read more
Bust These 4 Consultation Myths -- and Earn Full Payment
You may be able to code consults more often than you think Better safe than sorry, many... Read more
Reader Questions:
Keep V58.11 for Antineoplastic Agent
Question: When I use a chemo admin code for a drug that isn't chemo (such as Remicade or... Read more
Reader Questions:
Match Payer to Flu Vaccine Code
Question: We-ve been offering flu shots to some of our patients. How should we report th... Read more
Reader Questions:
NOC Code Holds the Ixabepilone Key
Question: What HCPCS code should I use for ixabepilone? Tennessee Subscriber Answer:... Read more
Reader Questions:
Stick to Single 36430 Unit
Question: Should I base the number of units for 36430 on the number of blood product uni... Read more
You Be the Coder:
Choose Proper RA Codes
Question: What codes should I report if we infuse a patient with refractory anemia using... Read more
CPT 2008 Update:
At Last -- a Code for Multiple Pushes of the Same Drug
Also coming next year: A code for PICC blood drawsWhen a patient needs more than one IV pu... Read more
Get the CPT 2008 Rundown Here
        Stay on top of next year's new and revised oncology and ... Read more
Look for Debut of Online, Phone E/M Codes
Key: If phone call leads to office visit, you can't report bothIn 2008, CPT will finally c... Read more
Meet the 16-Minute Mark to Code for Infusions
Time matters on multi-substance infusion sessionsWhen your oncologist performs an infusion... Read more
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Speed Up Your Chemotherapy Drugs HCPCS Coding
Use our chart to find the right code right now.With more than 60 different drugs your onco... Read more
READER QUESTIONS:
Know Your Terms for Easy Neoplasm Coding
Question: I-m new to coding and unfamiliar with neoplasm terminology. Specifically, what a... Read more
You Be the Coder:
Sandostatin Injections
Question: How should I code Sandostatin IM injections? I thought the correct code was 9072... Read more
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