Advanced Search

Oncology & Hematology Coding Alert

Tackle 77280-77295 1 at a Time for Watertight Simulation Claims
Ace complex vs. 3-D to earn an extra $200. You may have only one chance to report simulat... Read more
77280-77295:
Check for These W's to Master Simulation Requirements
Lay the foundation for simulation coding perfection with these five essentials. Who: "Only... Read more
Clinch E/M + Chemo Pay Using These CMS Guidelines
Here's why 99211 flashes a bright red 'audit me' sign at payers. At roughly $60 a pop, mi... Read more
Reporting Kaposi's Sarcoma? Size Up Need for Second Code
Jot this important note next to 176.x in your manual. If you stop your search for a Kapos... Read more
News You Can Use:
Factor G9141 Into Your Flu Vaccination Plans, CMS Says
Plus: Keep an eye out for proper use of new bevacizumab code. If you're planning to admin... Read more
Correction:
Restrict V58.61 to Secondary Spot
For your PT test monitoring encounters, be sure to limit V58.61 to the secondary diagnosis... Read more
READER QUESTIONS:
Turn to 36593 for Device Declotting
Question: Is 37201 appropriate when the patient comes to the infusion center with a clott... Read more
READER QUESTIONS:
Stick to Outpatient Codes for Observation
Question: A hematologist sees a patient for a consult on his first day in observation and... Read more
READER QUESTIONS:
Auto- Vs. Allo- Doesn't Change Harvest Coding
Question: Is there a CPT code specific to harvesting bone marrow for autologous transplan... Read more
READER QUESTIONS:
Payers Pick IMRT/Device Rules
Question: We're having a debate about whether we may report the professional component of... Read more
You Be the Coder:
Put Palliative Code in Proper Place
Question: A patient presents for palliative radiation therapy aimed at a secondary neopla... Read more
Here's Why Simultaneous Infusions Don't Always Equal 'Concurrent' Code
Learn 2 key lessons about when to keep +96368 off of your claim. If you've got questions ... Read more
Tackle Tongue Coding Head On With 141.x Anatomic Insights
Think 'base of tongue' refers to the underside? Think again. Oral cancer is on the rise, ... Read more
READER QUESTIONS:
Use J9999 for Temozolomide for Now
Question: What J code should I report for intravenous temozolomide? New Jersey Subscriber... Read more
READER QUESTIONS:
CMS Should Allow 99406 + E/M
Question: May I report 99406 and 99407 in addition to the regular E/M visit that a patien... Read more
READER QUESTIONS:
Remember 2009 Code Change for Breast HDR
Question: What are the proper codes for a patient with ductal carcinoma in situ who recei... Read more
READER QUESTIONS:
Ask for Extra Dehydration Details
Question: I know anemia diagnosis coding varies based on whether anemia results from mali... Read more
READER QUESTIONS:
Gather Guidelines, Avoid Extra PFSH Work
Question: Is the oncologist required to document a new PFSH if it hasn't changed since th... Read more
READER QUESTIONS:
Multiple Ovarian Cancer Types Fall Under 183.0
Question: Is there a specific code for primary clear cell ovarian cancer? Delaware Subscr... Read more
READER QUESTIONS:
Choose Proper Admin Code for Herceptin
Question: Which infusion code category should I use for Herceptin? Iowa Subscriber Answer... Read more
You Be the Coder:
Set Your Sights on 77321 Success
Question: Is 77321 appropriate for all electron services? California Subscriber Answer: N... Read more
Knock +96415, +96417 Claims Out of the Park With This Case Study's Help
Take the mystery out of 'each additional sequential infusion' vs. 'each additional hour.'... Read more
Wrap Up Treatment Plan Claims With Code-by-Code Analysis
Knowing simple vs. complex brings an $80 reward. Radiation treatment planning is complex ... Read more
News Flash -- 2010 May Bring the End of Consult Codes
Plus: The OIG feels your pain over inconsistent drug admin code policies. Oncology coding... Read more
Conquer In-Office Coumadin Coding, Easy as 1-2-3
Watch the diagnosis -- you may be surprised at the first-listed code. Don't get stuc... Read more
Reader Questions:
Just Say No to 61796-62
Question: When a neurosurgeon and radiation oncologist work together for stereotactic rad... Read more
Reader Questions:
Skip +96376 on Physician Claim
Question: If I code for the physician, am I supposed to report +96376 for services that a... Read more
Reader Questions:
No Mod 26 for This 55876 Guidance Claim
Question: If the radiation oncologist places fiducial markers into the prostate using ult... Read more
Reader Questions:
Toss Secondary Dx Requirement for V70.7
Question: Where can I find the official rule on using V70.7 on clinical trial claims with... Read more
You Be the Coder:
Research Zevalin Before You Code
Question: When I looked up Zevalin, I found out it's a monoclonal antibody. Does that mea... Read more
Prevent HCPCS Mistakes From Chipping Away at CHOP Reimbursement
Here's why you shouldn't report every drug in the regimen. An oncologist may prescribe a ... Read more
News You Can Use:
Catch This 77421 Supervision Switch, and Free the MD's Time
A fee schedule update offers a spot of physician supervision clarity. You can mark one in... Read more
Do Admit Codes and Admission Have to Show Same DOS?
Overlook this rule, and risk leaving rightful E/M dollars on the table. When the oncologi... Read more
To Do:
Add Q2023 to Medicare Payable List
But check the status indicator for this July 1 code. Medicare's July 2009 HCPCS update in... Read more
Reader Questions:
Record Reason for Lengthy Infusion Time
Question: The oncologist ordered a 90-minute chemotherapy infusion service, but the infus... Read more
Reader Questions:
Watch These Oral Emend Requirements
Question: We've been getting conflicting information on reporting oral Emend for patients... Read more
Reader Questions:
Report HDR per Treatment
Question: Should we code HDR and its components once or twice each day if we perform trea... Read more
Reader Questions:
Sort Through LCDs for Rituximab Coverage
Question: Is thrombotic thrombocytopenic purpura a covered diagnosis for Rituximab infusi... Read more
You Be the Coder:
Determine Proper Treatment Device Coding
Question: If the patient requires both a mask (complex) and a bite block (intermediate), ... Read more
ICD-9 Update:
TakeYour Coding Specificity Up a NotchWith 7 2010 Changes
Tumor lysis syndrome is getting its own code -- will you know where to lo... Read more
Don't Let 2010's Thrombosis Codes Derail Your Claims
Acute vs. chronic will be 1 key to your 2010 ICD-9 choice. Whether you code for a hema... Read more
Look Beyond New ICD-9 Code List for Clean Claims Clues
Watch for these 2 still-to-come notes and index changes. As long as... Read more
Get an Edge on 2010's All-New Embolism Coding
Expect upper extremity changes for Oct. 1. NEW: Pulmonary Embolism ... Read more
READER QUESTIONS :
57155 Pay Is for Performance
Question: If the radiation oncologist attends a uterine tandem surgery placeme... Read more
READER QUESTIONS :
CMS Says 52 and E/M Don't Mix
Question: If an E/M code requires three components, but we dont have documenta... Read more
READER QUESTIONS :
Vocab Boost: Understand Hyperfractionation
Question: What exactly is hyperfractionation? Pennsylvania Subscrib... Read more
READER QUESTIONS :
Match All Venofer Requirements
Question: My hematologists Venofer claims have been getting denied. Can you co... Read more
You Be the Coder :
Recognize Proper Ommaya Code
Question: My practice is debating whether 61026, 96450, or 96542 is the most a... Read more
CCI Update:
Pinpoint the Radiation, Chemo, and Hematology Codes in 304,000 New Edits
CMS uses the latest round of edits to do some spring cleaning. The ... Read more
News You Can Use:
Chart the Changes to CMS's New Oncologic PET Policy
NOPR stats help boost coverage for your patients. Whether your clin... Read more
77300 in Focus:
Dig Into 2 Dosimetry Examples and Unlock Payment
Heres 1 question you must put to your payer. The descriptor for 773... Read more
READER QUESTIONS:
Leave Mod 59 for Multiple Encounters
Question: Should I append modifier 59 when I report multiple chemo or therapeu... Read more
READER QUESTIONS:
Check Payer's 77427 DOS Preference
Question: The guidelines for 77427 say you may report the code for five fracti... Read more
READER QUESTIONS:
Guidelines Take Guesswork Out of V58.11
Question: Should I report a V code as primary for every encounter that include... Read more
You Be the Coder:
Consider Same-Day Infusion/Initiation Codes
Question: Which CPT codes should I report for the following case? "... Read more
Case Study:
Tackle This Infusion Coding Service Successfully From Start to Finish
See what the authorities say about billing concurrent saline -- CPT and HCPCS. Si... Read more
Put 'Push' Questions Behind You
Dont get stuck in the trap of assuming you can code a push only if the service... Read more
250 cc D5W? Watch Your Step
Several payers have guidelines stating you should not report fluids unless you m... Read more
Keep Track of Services Included in Infusion
You should not report the following separately if performed to facilitate a therapeutic/... Read more
203.x0:
Shine the Spotlight on Multiple Myeloma ICD-9 Coding
Simplify your coding choices when documentation doesnt go into specifics. ... Read more
Master CMS Observation Rules to Breathe Easy at Audit Time
Count the hours for single-day stays, or beware the consequences. P... Read more
READER QUESTIONS:
Follow 'Quality' Examples for HPI
Question: Can we use the patients diagnosis as quality under HPI? Maryland Subscriber ... Read more
Clarification:
Clarification:
Expand Your Med Options With Torisel, Treanda Codes in Oncology and Hematology... Read more
READER QUESTIONS:
Multiple Codes Cover Port-a-Cath Malfunction
Question: Which diagnosis code is appropriate for malfunctioning of a Port-a-C... Read more
READER QUESTIONS:
Treat 2 Areas, Double Neoplasm Dx
Question: Which diagnosis codes should I report when a patient presents for ra... Read more
READER QUESTIONS:
New to Blood Draw Coding? Read This
Question: We normally draw a patients blood and do a CBC in our office. Recent... Read more
READER QUESTIONS:
Link Lactated Ringer's to J7120
Question: Which HCPCS code should I report for a lactate ringer bag? ... Read more
READER QUESTIONS:
Supply May Be Key to Transfusion Payment
Question: Should I report 36430 twice if we supply both packed red blood cells... Read more
READER QUESTIONS:
Choose 77427 -- Not E/M -- for Weekly Check
Question: Ive just started coding radiation oncology and heard the oncologist ... Read more
You Be the Coder:
Code Scope Based on Exam or Entry Site?
Question: A patient presented for a larynx examination to see how shes respond... Read more
96401-96549:
Translate 'Other Highly Complex Drug' Into Real-World Success
Find out where Noridian and NGS fall on which drugs deserve chemo codes. One of the fir... Read more
Ease Your J0881, J0885 ESA Coding Woes Today
Have you sent your software vendor this crucial instruction? CMS released a slew of doc... Read more
Keep Tabs on This ESA Timeline
-ESA treatment duration for each course of chemotherapy includes the 8 weeks following t... Read more
Discover What 'Most Recent' HGB/HCT Means
Medicare asks for the -most recent- HGB or HCT count. The good news is CMS doesn't expec... Read more
READER QUESTIONS:
Dig Into Special Dosimetry Requirements
Question: I got a charge sheet with 77331 circled. The physician ordered special monitor... Read more
READER QUESTIONS:
Investigate 99060 Payer by Payer
Question: Our oncology nurses asked me to investigate 99060. Should I report this code f... Read more
READER QUESTIONS:
Consistency Is Key to Plan Coding Date
Question: Should I charge for computer generated treatment plans on the day of the print... Read more
READER QUESTIONS:
Reinstated Code J1750 May Cause Trouble
Question: Is there a new code for INFeD iron dextran? My J1751 claims are being denied. ... Read more
READER QUESTIONS:
Bone Up on E-Scribe 2 Percent Bonus
Question: I heard that physicians may receive bonuses for e-prescribing. What codes woul... Read more
READER QUESTIONS:
Create an Image Fusion Claim Strategy
Question: What is the proper CPT code for image fusion when the patient has stereotactic... Read more
You Be the Coder:
Keep Hydration Coding on Course
Question: The oncologist often orders a 35 minute intravenous infusion of Phenergan with... Read more
CCI 15.0:
Brace Yourself for Massive Edits to Brachytherapy, Injections, and Infusions
Hint: If it's a new code for -09, it probably has an edit. CPT 2009 overhauled your cod... Read more
Expand Your Med Options With Torisel, Treanda Codes
Find out which code payers might pair with 189.0. Your fallback for some cancer medica... Read more
Here's Your Easy Answer to ROS Levels
Keep this guide to stay on track with what constitutes levels. When you file E/M claim... Read more
Reader Questions:
Omitting G Code Could Stall Aspiration Pay
Question: According to CCI edits, we can bill 38221 with 38220 and modifier 59, but I co... Read more
Reader Questions:
Quick Stop Doesn't Justify Second 96413
Question: We began a chemotherapy infusion and ran it for two hours. The nurse stopped t... Read more
Reader Questions:
Lung Diagnosis Goes Further Than 162.9
Question: Should we submit separate diagnoses for non-small cell lung cancer (NSCL) and ... Read more
Reader Questions:
Spinal Infusion' Equals 96450
Question: The treatment plan says the patient will receive chemotherapy by spinal "infus... Read more
Reader Questions:
Lowdown on New Fifth-Digit Classifications
Question: Some oncology diagnosis codes for 2009 include changes to the fifth-digit clas... Read more
Reader Questions:
77295 Includes 77014's CT Guidance
Question: Can you explain why CPT 77014 is bundled with 77295? I-ve looked on the Medicar... Read more
Reader Questions:
Keep J9999 for Claim Before J9303 Intro
Question: A patient received Vectibix before J9303 was introduced, so we submitted the c... Read more
You Be the Coder:
Best Dx for Diffuse Large Cell Lymphoma
Question: Which diagnosis is more appropriate for diffuse large cell lymphoma: 202.80 or... Read more
Documentation:
New ABN Implementation Is Coming: Are You Ready for Supply or Test Changes?
Updated form replaces existing ones March 1. Almost a year ago -- March 3, 2008&nb... Read more
Focus on the Basics to Simplify Your ABN Filing
Remember these 4 tips and stay on track for success. Although the ABN form has changed ... Read more
Switching to EHR? Weigh These Pros and Cons First
Caution: You might not be able to track who makes changes. With new technology emerging... Read more
News Flash:
Fusilev Earns Its Own J Code
Medication might help fight leucovorin shortage -- but at a price. A nationwide sh... Read more
Reader Questions:
Keep Clear of J1642 With 36000
Question: Someone recently told us that we could submit J1642 with 36000-59. We administ... Read more
Reader Questions:
Only Report Irrigation, Not Office Visit
Question: When a patient presents for venous device irrigation, should we only bill 9652... Read more
Reader Questions:
Document Need for 36591
Question: How should we submit a blood draw when that's the patient's only service of th... Read more
Reader Questions:
Primary Reason Goes Before Prophylactics
Question: We administer prophylactics such as potassium, then chemotherapy, then other p... Read more
Reader Questions:
Only Code Follow-Up If Unrelated Reason
Question: Under normal circumstances we cannot bill a follow-up within 90 days of a pati... Read more
Reader Questions:
Add 59 for Second Site, Separate Charge
Question: We completed a complex teletherapy isodose plan and basic dosimetry calculatio... Read more
Reader Questions:
New 999.8x Codes Pinpoint Extravasation Diagnosis
Question: We have a chart with the finding "extravasation of vesicant chemotherapy." Wha... Read more
You Be the Coder:
Diagnosing Endometrial Stromal Sarcoma
Question: What is the correct diagnosis code for endometrial stromal sarcoma? Florida S... Read more
HCPCS 2009:
You'll Have to Stop Coding G0332;Feds End Stopgap IVIG Funding
Plus: Add a stack of J-codes to your toolkit to prevent 2009 denials For 2009, you-ll f... Read more
CPT 2009 Moves Infusion Code Set
Learn the new numbers and avoid rejection problems. HCPCS codes aren't the only ones t... Read more
Watch for Changes in High-Dose Brachytherapy Coding
Descriptors for new codes alter your claims and could hurt your bottom line. CPT 2009 o... Read more
Use These History Tips to Clean Up Physician's Documentation
With others involved, you can deliver the best possible claim. Helping your oncologist ... Read more
Reader Questions:
You Need More Info From Your Doctor for This Dx
Question: What is the diagnosis code for paraneoplastic syndrome? California Subscribe... Read more
Reader Questions:
Details Can Help Get 77300 Paid
Question: How many units can I report when billing 77300? I-m trying to be paid for five... Read more
Reader Questions:
Report 77470 Once " If At All
Question: A consultant once told us to include 77470 with time-consuming or complex trea... Read more
Reader Questions:
Don't Code Built-In Service as Separate E/M
Question: A nurse practitioner (NP) sees a 65-year-old established patient. Before admin... Read more
Reader Questions:
How Long Do I Wait to Code 'History Of'?
Question: A patient had rectal cancer in 2001 and is coming in now for a follow-up yearl... Read more
You Be the Coder :
It's a Familiar Drug, but What's the Code?
Question: What is the correct code for billing cimetidine 300 mg intravenously to Medica... Read more
Do You Need to Change First-Listed Diagnosis for a Secondary Cancer Site?
Here's what to do when treatment aims change. Ever get confused between first-listed an... Read more
What the Guidelines Say About Coding Neoplasm Diagnoses
Here are some useful tidbits from "ICD-9-CM Official Guidelines for Coding and Reporting" ... Read more
Split Radiation Procedures:
Into Pro, Tech Without Denials
Find out what conditions you must meet to keep the auditors at bay. If you forget to ap... Read more
Watch for Radiation Oncology Procedures With PC/TC Split
Keep an eye on the Medicare Physician Fee Schedule to see which procedures may be split in... Read more
News You Can Use:
CMS Allows NCCN Compendium as an 'Off-Label' Reference
-Recommended- will mean medically accepted. Until recently, the only readily available ... Read more
Stay Tuned:
CPT 2009 Shakes Things Up for Infusion Coding
As soon as your CPT 2009 manual hits your desk, make a beeline for the medicine section. T... Read more
Reader Questions:
How Do I Code Multiple Concurrent Infusions?
Question: How many times may I report +90768 per encounter? Iowa Subscriber Answer:... Read more
Reader Questions:
You Can't Share a Consult
Question: I know that a nonphysician practitioner and an oncologist can "share" an ... Read more
Reader Questions:
Include Port Flush in Chemo Administration
Question: Can I claim 36410 and 90774 if the patient presents weekly for flushing an ext... Read more
Reader Questions:
ICD-10 Will Make Dx Codes Longer
Question: Whatever happened to ICD-10? Is that coming out soon? Mississippi Subscriber ... Read more
Reader Questions:
Neoplasm Dx Goes First With Estrogen Status
Question: Can you explain how to report estrogen receptor status? Must you report a brea... Read more
You Be the Coder:
Does Sandostatin Count as Chemo?
Question: Are Sandostatin Depot injections considered nonhormonal chemo injections (9640... Read more
Available Years:  2009  2008  2007  2006  2005  2004  2003  2002  2001  2000  1999