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Oncology & Hematology Coding Alert

HCPCS 2011:
J9080-J9097 Head to the Chopping Block in 2011
Learn which other codes will bring you instant denials starting January 1.The recently rel... Read more
HCPCS 2011:
J9302, J9307, and J9315 Offer New Options for Lymph Cancer Drugs
Watch for these drugs when other treatments have failed.You'll have a trio of new J codes ... Read more
Vaccinations:
90663-90668 Don't Belong on Your Medicare Claim
Keep these rules in mind for H1N1 coding.Several codes for pandemic formulation flu vaccin... Read more
2011 Fee Schedule:
Will CMS Slash 2011 Conversion Factor by Over 30 Percent Versus Current Rates?
Oncology RVUs should stay close to 2010 levels.Another season of nail-biting is under way,... Read more
Reader Questions:
G0436-G0437 Join Smoking Cessation Options
Question: I heard we're supposed to use G codes instead of CPT codes for tobacco cessation... Read more
Reader Questions:
77280 Better Than 77290 for Verification Simulation
Question: How should we report the simulations performed to check applicator position in p... Read more
Reader Questions:
Q2035-Q2039 Represent CMS Flu Vaccine Supply
Question: Should we use a HCPCS code for basic flu vaccine supply?Answer: Assuming you're ... Read more
You Be the Coder:
G0364: Report It Alone or With Another Code?
Question: I'm confused about proper use of G0364. Should we report it by itself to represe... Read more
CPT 2011:
96445 Is Out, 96446 Is In for Peritoneal Cavity Coding as of Jan. 1
Add to your understanding of what's in store for oncology and hematology in 2011.The New Y... Read more
CPT 2011:
99224-99226: See Subsequent Observation Care Codes for Yourself
The OIG is watching observation coding, so be sure you are, too.Last month's issue of Onco... Read more
CCI 16.3:
88738 Bundle With 85025 and 85027 Has a New Modifier Indicator … Again
Noting the retroactive date could pay off.If your center has a lab, it might get a request... Read more
E/M:
Nail Down Answers to E/M Documentation Questions
Guidelines and an FAQ response offer insights on who's responsible.Warning: Don't let your... Read more
Reader Questions:
238.75 Belongs on HSCT Claim
Question: I understand there's a national coverage determination that says Medicare covers... Read more
Reader Questions:
790.93 Describes Elevated PSA
Question: Our center performs its own diagnostic PSA tests for patients diagnosed with BPH... Read more
Reader Questions:
Catch Up on Incomplete Claims
Question: Our practice has a few claims that have missing or incorrect information. I'm no... Read more
Reader Questions:
99204-99205 Require Complete PFSH
Question: I'm new to E/M coding, and I have a question about past, family, and social hist... Read more
You Be the Coder:
Which Codes Apply to ECG Screening?
Question: Which diagnosis code should we use when we perform ECGs on asymptomatic patients... Read more
ICD-9:
Part 2: Find All 5 Hodgkin's Lymphoma Digits
Plus see how your ICD-9 and ICD-10 options compare.Choosing the appropriate ICD-9 code for... Read more
CPT 2011 Update:
Expect New Codes for Peritoneal Cavity Chemo and Interstitial Device Placement
Watch for new subsequent observation codes, too.If your practice provides chemotherapy int... Read more
Drug Reimbursement:
Verify That LCA Pay Rates Are History for Lupron Depot
Check your LCDs for information on J9217 reimbursement.Has your practice checked that it's... Read more
News You Can Use:
Tackle 2 CCI and ICD-9 Announcements From CMS
Learn the answer to whether an ICD-9 update freeze will go through.Here's the scoop on two... Read more
Reader Questions:
Apply Surface Application Code for This Case
Question: Our practice recently started providing eye treatment using Strontium 90. Which ... Read more
Reader Questions:
Pick Polyp Diagnosis Based on Pathology
Question: I'm confused as to whether tubulovillous adenoma colon polyps are classified as ... Read more
Reader Questions:
Don't Code Disconnect Without Checking Payer
Question: Is there a 24-hour pump disconnect code, or should we code an office visit?Conne... Read more
You Be the Coder:
Mull Over Chemo Admin in Hospital
Question: If the physician administers chemotherapy into an Ommaya reservoir in the hospit... Read more
Infusion Coding:
Part 1: Watch HCPCS to Clinch Clean
See how your day 1 coding differs from day 15. The Stanford V regimen involves seven basi... Read more
Clip and Save:
Pick Stanford V HCPCS Using This Handy Table
See how many times per cycle you should expect to report J9230. Each new week brings a ne... Read more
News You Can Use:
Get Up to Speed on CMS's Modifier JW and 99406/99407 Announcements
If you were confused by Transmittal 1962, you weren't alone. Coding for discarded drugs a... Read more
Chemotherapy:
Take a Closer Look at Adverse Reaction Coding
Remember that you don't need two separate diagnoses for chemo plus E/M. "Seize Every Code... Read more
E/M Coding:
Knock Out Questions on New/Established Patient E/M
Remember, what used to be a consultation is now likely a 99201-99215 service. Suppose the... Read more
Reader Questions:
Breakdown Breast Brachytherapy Codes
Question: What's the difference between 19296-+19297 and 19298? North Carolina Subscribe... Read more
Reader Questions:
Seek Clarity on CLL Abbreviation
Question: I have documentation showing the diagnosis CLL. What does this stand for and wh... Read more
Reader Questions:
Pick V07.8 for Prophylactic Radiation
Question: We have a patient with small cell lung cancer. The oncologist has ordered radia... Read more
You Be the Coder:
Check for Symptoms Before Using V71.1
Question: When is use of V71.1 correct? Arizona Subscriber Answer: Code V71.1 (Observati... Read more
Back to Basics:
4 Tips Help Keep Your Chemo Admin Coding on the Straight and Narrow
Boost your efficiency using infusion documentation sheets.Accurate infusion coding starts ... Read more
News You Can Use:
Take a Quick Tour of Recent CMS Announcements That Affect You
See what's new for drug payment, PET coverage, and HSCT trials.Summer may be winding down,... Read more
CCI Update:
Apply Most Recent CCI Version or Face CBC Denials
Modifier indicator change from '1' to '0' ties labs' hands.Correct Coding Initiative (CCI)... Read more
Radiation Oncology:
Pinpoint Urologist Vs. Oncologist Services for Pristine Brachytherapy Coding
Differentiate seeds and markers before choosing 55875 or 55876.Brachytherapy seed placemen... Read more
Reader Questions:
Tackle TPA Installation for Declot
Question:We had a patient come into the clinic for a TPA installation to break up blockage... Read more
Reader Questions:
Hold On to 'History of' Code in This Case
Question:A patient had been free of her breast cancer for two years and receiving no treat... Read more
Reader Question:
Watch 36430 Units -- RACs Are
Question:If we give two units of blood, should we report 36430 twice?Arkansas SubscriberAn... Read more
Reader Question:
Work, Not Circumstance, Supports 77470
Question:Does presence of a cardiac device (like a pacemaker) qualify as a reason to code ... Read more
You Be the Coder:
Pick Proper Codes for Palliative Case
Question:Which ICD-9 codes should I use for the following case? The patient presents for e... Read more
CCI Update:
Watch for New Edits Hitting Brachytherapy and Heparin Codes
Pay close attention to modifier indicators -- and when modifier 59 is safe to use.Effectiv... Read more
ICD-9 Coding:
Follow These Tips to Feel Certain About Coding Uncertain Neoplasms
Mastering uncertain vs. unspecified is an oncology coding essential.Unless you've got the ... Read more
CCI Update:
Don't Overlook Hospital Visit/Radiation CCI News
When you're reviewing the Correct Coding Initiative (CCI) version 16.2 changes, remember t... Read more
Reader Questions:
Pick 233.4 for PIN III
Question: The oncologist notes that a prostate biopsy reveals "high-grade prostatic intrae... Read more
Reader Questions:
Nix Reporting NS Concurrent With Chemo
Question: If the patient receives saline (NS) concurrently with chemotherapy for hydration... Read more
Reader Questions:
2 Modalities Still Equal 77263 x 1
Question: When a course of therapy involves both brachytherapy and external beam therapy, ... Read more
Reader Questions:
Match J9303 to Chemo Admin Codes
Question: I had a claim for J9303, 96413, and +96367 rejected. Are these the correct admin... Read more
Reader Questions:
Take Care When Choosing NDC
Question:Where can I find an NDC number for J0881?New York SubscriberAnswer: You'll need t... Read more
You Be the Coder:
Take the Chemotherapy Coding Challenge
Question:How should I report the following case?Primary diagnosis is lung cancer, primary ... Read more
Estrogen Receptor Status:
3 Questions Clarify V86.0 Use for Current Breast Cancer Coding Success
Learn which code you should add for patients on tamoxifen therapy.Skipping secondary ICD-9... Read more
174.x In Focus:
Check This Chart for Accurate Female Breast Neoplasm Coding
Don't miss the difference between 'other' and 'unspecified.'Pinpointing anatomic location ... Read more
Radiation Oncology:
Get Up to Speed on IGRT Coding to Claim Your Imaging Dollars
Don't forget to hit the Category III section for your most recently added option.Imaging t... Read more
Reader Questions:
Pick Up on Q2025 Payment Status
Question: CMS lists payment status "E" for new HCPCS code Q2025. What does "E" mean? Arkan... Read more
Reader Questions:
Define 'Impacted' for 69210 Success
Question: Our oncologist sometimes decides a patient with head and neck cancer needs earwa... Read more
Reader Questions:
Prepare to Code Oncologic PET Trial Claims
Question: Medicare covers NaF-18 PET to identify bone metastasis only for patients in a cl... Read more
Reader Questions:
Let Lab Report Lab Code
Question: Our oncologist wants to report 85097 when he takes a bone biopsy, looks at the s... Read more
You Be the Coder:
Dig Into Hypothyroidism Dx
Question: An established patient who recently had surgery and radiation therapy to treat t... Read more
ICD-9 2011:
Hammer Out Your Game Plan for New Transfusion-Reaction Diagnosis Codes
Everything from TACO to iron overload has a chance at more specific options.If you have pa... Read more
Radiation Oncology:
3 Steps Take Your Radiation Treatment Coding to the Next Level
Keep your hands off 77402-77416 if you bill professional only.If you don't understand the ... Read more
Infusion Coding; Ace CPT and ICD-9 Coding for Intra-Arterial Cases
Whether liver neoplasm is primary or secondary will change your coding.Good news: You can ... Read more
Reader Questions:
Let Contractor Guide JW Use
Question: Is the point of new MLN Matters article MM6711 that modifier JW use is now manda... Read more
Reader Questions:
Thumbs Up to 36592 + 85025
Question: The CPT manual includes a note under 36592 to not report the code with any other... Read more
Reader Questions:
Watch Treatment Week for 77417
Question: We're an independent facility that performs and reports port films for our radia... Read more
You Be the Coder; Determine Proper Adverse Reaction Code
Question: If a non-Hodgkin's lymphoma patient has an adverse reaction to Rituximab less th... Read more
Center Your Focus on Cyclophosphamide for Better Breast Cancer Coding
Watch out: The 'T' in TC may not stand for what you think. In recognition of Natio... Read more
Part 2:
3 More FAQs Take Your 77427 Coding to the Next Level
Put this handy chart to work tracking your weekly management visits. Understanding 77427 ... Read more
News You Can Use:
Keep Signature, Modifier 59, and 'Incident To' Guidelines Front and Center
2 compliance updates keep your coding in the clear. If you've been worrying that the onco... Read more
Reader Questions:
Zero In on Xerostomia Coding
Question: If we provide amifostine for a lip cancer patient receiving radiation, which d... Read more
Reader Questions:
Append Modifier Q6 for Fill-In Physician
Question: We hired a locum tenens for two weeks. Do we code the same for the replacement ... Read more
Reader Questions:
Remember +99354 30-Minute Minimum
Question: The oncologist documented 60 minutes for an established patient office visit. S... Read more
Reader Questions:
Limit Yourself to 1 Unit of 77418
Question: If the oncologist treats multiple fields using IMRT in a single session, should... Read more
You Be the Coder:
Decipher This Decitabine Case
Question: We're a freestanding facility. How should I report a 61-minute infusion of deci... Read more
Master the ABCs of ABVD With These HCPCS and CPT Essentials
Make this J9040 slip, and you'll report 15 times more units than you should.The ABVD regim... Read more
Part 1:
3 FAQs Clear Up the 77427 5-Fraction Mystery
Master the math required for accurate 'weekly' reporting. CPT and CMS offer helpful rul... Read more
CPT Notes Bolster 'Initial' Code Choice
CPT's infusion guidelines state that for physician services, "the 'initial' code that best... Read more
Clip and Save:
Simplify ABVD Regimen Coding, Easy as 1-2-3
Speed your coding for ABVD chemotherapy coding with this handy summary of the codes most l... Read more
CMS Speaks:
Weigh Your 2-Payer Consult Coding Options
In MSP cases, non-consult code for both payers may be best. If you have payers who didn't... Read more
Reader Question:
Match 55876 and A4648 on Your Claim
Question: I've been coding A4648 with 55876, but CMS Transmittal 604, CR 6579, has me worr... Read more
Reader Question:
Put Pump Questions to Rest
Question: Following up on "Factor In These Codes for FOLFOX4" in Oncology & Hematology... Read more
Reader Question:
Base Bruising Code on Symptom
Question: The only information related to diagnosis we have for one of our new hematology ... Read more
Reader Question:
Decide Between V58.11 and V58.12
Question: How do I choose between V58.11 and V58.12?Illinois SubscriberAnswer: Distinguish... Read more
You Be the Coder:
Ace Apheresis Coding
Question: Which CPT code describes apheresis for a leukemia patient?Idaho SubscriberAnswer... Read more
Seize Every Code When Chemotherapy Results in Adverse Reaction
Recognizing critical care services can add $258 to your bottom line. If your oncologist h... Read more
ICD-9:
Don't Miss These Adverse Reaction Do's
In the case of a terminated chemotherapy infusion due to patient reaction, your payer may ... Read more
Satisfy SIRS ICD-9 Requirements With Pinpoint Precision
Plus: Get a glimpse at ICD-10's R65.1x section. When the oncologist documents SIRS result... Read more
Excel at Critical Care Coding by Mastering Include/Exclude Rules
Don't let condition alone lure you into reporting 99291. You can maximize your E/M coding... Read more
Reader Questions:
Verify V70.7 Placement for Healthy Volunteer
Question: I'm confused by Medicare Transmittal 1901. How does it change our current outpa... Read more
Reader Questions:
Pull Out Your Red Pen: 49410 Errata
Question: I was looking through the codes for interstitial device placement in the AMA CP... Read more
Reader Questions:
Add V10.x to V67.x for 'Full Picture'
Question: Suppose a patient presents for periodic visits to see if a colon carcinoma has ... Read more
Reader Questions:
Place 59 on Col. 2 Code, Usually
Question: Different insurance companies tell me different things about where to place mod... Read more
Reader Questions:
Watch 3 Key Areas for Modifier GV
Question: When is it correct to use modifier GV? Iowa Subscriber Answer: You should appen... Read more
You Be the Coder :
Code HEM + Biopsy Correctly
Question: Sometimes the oncologist/hematologistsees a patient for the first time; perform... Read more
Bone Up on 38220, 38221, and G0364:
CMS Coding Guidelines in Focus
Don't sweat reporting 38220-59 if you meet these Medicare-approved conditions. If your on... Read more
Capture Lab Services Correctly Using 3 New Codes
Watch for your chance to replace 86316 with more specific 86305. If your oncology prac... Read more
Keep Medicare's Bone Marrow Coding Rules Straight At a Glance
This handy chart is the solution to your G0364 confusion. Bone marrow services offer all ... Read more
2 Tips Help You Apply New Code 31626 With Confidence
Simplify choosing between 31626 and 32553 with 1 easy strategy. Radiation oncologists oft... Read more
Streamline E-Scribe Coding From 3 Codes to 1
2010 brings a new code and a new number to meet if you want your bonus. Physicians who ad... Read more
Reader Questions:
Cheer CCI Change for E/M and Radiation Codes
Question: Did the January Correct Coding Initiative (CCI) release delete the edits bundli... Read more
Reader Questions:
Factor In These Codes for FOLFOX4
Question: What are the appropriate codes for the first day of the FOLFOX4 regimen? New Je... Read more
Reader Questions:
Update Your PET for Cervical Cancer Coverage
Question: Does Medicare still require modifier Q0 on PET claims for cervical cancer? Wash... Read more
Reader Questions:
Avoid Moderate Sedation Code on 77371 Claim
Question: My CPT 2010 manual indicates that 77371 has been revised, but the definition lo... Read more
You Be the Coder:
Does Recurrence Change ICD-9 Option?
Question: How do you code recurrence of a tumor such as breast or lung? Is it a primary s... Read more
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