Oncology & Hematology Coding Alert
Revenue Cycle Management:
Is Your EHR or Billing Software Sabotaging Your RCM?
How to spot-and stop-the tiny software glitches and user errors that can cause big billing... Read more
Is Your EHR or Billing Software Sabotaging Your RCM?
How to spot-and stop-the tiny software glitches and user errors that can cause big billing... Read more
Compliance:
Alleged EHR Glitch Leads to Whistleblower Suit
Here's one more reason for coders, billers and RCM professionals to understand what goes o... Read more
Alleged EHR Glitch Leads to Whistleblower Suit
Here's one more reason for coders, billers and RCM professionals to understand what goes o... Read more
Coding 101:
The Oncology Coder's Quick-Start Guide to Infusions and Medications
Confused about the difference between an injection and an infusion? Here's help. Just bec... Read more
The Oncology Coder's Quick-Start Guide to Infusions and Medications
Confused about the difference between an injection and an infusion? Here's help. Just bec... Read more
CDI:
What Oncology Coders Need to Know about Physician Queries
Read on for answers to your most frequently asked questions. Physician queries-and the an... Read more
What Oncology Coders Need to Know about Physician Queries
Read on for answers to your most frequently asked questions. Physician queries-and the an... Read more
You Be the Coder:
Can You Spot the Mistakes That Lead to Leading Queries?
Master writing techniques that transform a leading query into a non-leading query. 'Leadi... Read more
Can You Spot the Mistakes That Lead to Leading Queries?
Master writing techniques that transform a leading query into a non-leading query. 'Leadi... Read more
TCM:
Tackle 7 Questions to Catch Any TCM Coding Errors Before They Occur
Medication reconciliation and management must occur no later than date of face-to-face vis... Read more
Tackle 7 Questions to Catch Any TCM Coding Errors Before They Occur
Medication reconciliation and management must occur no later than date of face-to-face vis... Read more
ICD-10-CM:
Keep Your Dx Coding Sharp, now More than Ever
Capturing and coding patients' comorbidities affects reimbursement now, and later. Until ... Read more
Keep Your Dx Coding Sharp, now More than Ever
Capturing and coding patients' comorbidities affects reimbursement now, and later. Until ... Read more
Payment Models:
Get the Lowdown on HCC Scores and Risk Adjustment
Correctly coding comorbidities can mean a difference of hundreds-or thousands- of reimburs... Read more
Get the Lowdown on HCC Scores and Risk Adjustment
Correctly coding comorbidities can mean a difference of hundreds-or thousands- of reimburs... Read more
Reader Question:
Fuel CDI Efforts with Well-Designed Templates
Question: Yikes! There are tons of ICD-10-CM changes for oncology this year. More tha... Read more
Fuel CDI Efforts with Well-Designed Templates
Question: Yikes! There are tons of ICD-10-CM changes for oncology this year. More tha... Read more
You Be the Coder:
Observe these Shared, Incident-To Differences
Question: Can you please explain the difference between a split/shared evaluation and... Read more
Observe these Shared, Incident-To Differences
Question: Can you please explain the difference between a split/shared evaluation and... Read more
CPT® 2018:
Absorb How Your Bone Marrow Aspiration, Radiology Coding Will Change — Before Jan. 1 Hits
Performed both bone marrow aspiration and biopsy? Report only one code next year. Fall is... Read more
Absorb How Your Bone Marrow Aspiration, Radiology Coding Will Change — Before Jan. 1 Hits
Performed both bone marrow aspiration and biopsy? Report only one code next year. Fall is... Read more
CPT® 2018:
Pass Pathology Muster When it Comes Ordering These Lab Genetics
Overlooking these breast cancer revisions could impact your bottom line. One molecular pa... Read more
Pass Pathology Muster When it Comes Ordering These Lab Genetics
Overlooking these breast cancer revisions could impact your bottom line. One molecular pa... Read more
Treatment Planning:
Raise the Bar When It Comes to Radiotherapy Planning and Prep
Here's how to earn for 3-D planning, dosimetry calculation, and IMRT. If you're tearing y... Read more
Raise the Bar When It Comes to Radiotherapy Planning and Prep
Here's how to earn for 3-D planning, dosimetry calculation, and IMRT. If you're tearing y... Read more
Reader Question:
Two Sites Means Making Use of Your Modifiers
Question: If my oncologist administers Faslodex in two sites, should we bill it 96402... Read more
Two Sites Means Making Use of Your Modifiers
Question: If my oncologist administers Faslodex in two sites, should we bill it 96402... Read more
Reader Question:
Review These Bevacizumab Basics
Question: I am new to oncology coding. Which of the following codes should we submit ... Read more
Review These Bevacizumab Basics
Question: I am new to oncology coding. Which of the following codes should we submit ... Read more
Reader Question:
Simplify Smoking Cessation Counseling for Medicare Patients
Question: A Medicare patient with no symptoms of a tobacco related condition presents... Read more
Simplify Smoking Cessation Counseling for Medicare Patients
Question: A Medicare patient with no symptoms of a tobacco related condition presents... Read more
Reader Question:
Fixate on These Diagnosies for Fatigue
Question: A lot of cancer patients come into our office with complaints of fatigue. I... Read more
Fixate on These Diagnosies for Fatigue
Question: A lot of cancer patients come into our office with complaints of fatigue. I... Read more
You Be the Coder:
Hesitate Before Appending Modifier 76 to J9999
Question: We bill for medical oncology and use multiple dose forms of chemother... Read more
Hesitate Before Appending Modifier 76 to J9999
Question: We bill for medical oncology and use multiple dose forms of chemother... Read more
ICD-10-CM 2018 Update:
Minimize Mistakes By Learning New Malignant Mast Cell Disorder Diagnoses Now
Reflect greater detail for breast lumps, thanks to these new codes. If you're used to app... Read more
Minimize Mistakes By Learning New Malignant Mast Cell Disorder Diagnoses Now
Reflect greater detail for breast lumps, thanks to these new codes. If you're used to app... Read more
Biopsies:
3 Tips Draw the Line Between FNA Versus PNB Procedures
Watch out, or your mistake will cost you $64 per procedure. If your oncologist merely doc... Read more
3 Tips Draw the Line Between FNA Versus PNB Procedures
Watch out, or your mistake will cost you $64 per procedure. If your oncologist merely doc... Read more
E/M:
Receive a 99215 Denial? Expert Advice Will Show You What You Did Wrong
Hint: Always check the medical decision-making. Unfortunately, you may be one of the rank... Read more
Receive a 99215 Denial? Expert Advice Will Show You What You Did Wrong
Hint: Always check the medical decision-making. Unfortunately, you may be one of the rank... Read more
Reader Question:
Bundled Biopsies and Aspirations Depend on the Sites of Operation
Question: A patient underwent a bone marrow aspiration and biopsy and the oncologist ... Read more
Bundled Biopsies and Aspirations Depend on the Sites of Operation
Question: A patient underwent a bone marrow aspiration and biopsy and the oncologist ... Read more
Reader Question:
Be Certain Your 1995 Guidelines Are Current
Question: I have a old audit sheet that states for 1995 guidelines, and it states: P... Read more
Be Certain Your 1995 Guidelines Are Current
Question: I have a old audit sheet that states for 1995 guidelines, and it states: P... Read more
Reader Question:
Patient's Age Matters for Immunization
Question: I coded 90649, 99402 and 90471 for a patient who received the HPV vaccine a... Read more
Patient's Age Matters for Immunization
Question: I coded 90649, 99402 and 90471 for a patient who received the HPV vaccine a... Read more
You Be the Coder:
Coding for Fatigue? Look at These 2 Codes
Question: A lot of cancer patients come into our office with complaints of fatigue. I... Read more
Coding for Fatigue? Look at These 2 Codes
Question: A lot of cancer patients come into our office with complaints of fatigue. I... Read more
Stem Cells:
Follow These Do's and Don'ts for Stem Cell Transplant Coding
Key: Allogeneic vs. autologous mean different payouts. Stem cell transplants, used to tre... Read more
Follow These Do's and Don'ts for Stem Cell Transplant Coding
Key: Allogeneic vs. autologous mean different payouts. Stem cell transplants, used to tre... Read more
Evaluation and Management (E/M):
3 Factors That Can Trip You Up While Reporting for Oncological Office Visits
Key: A review of history determines the type of code to use. Office visits are where the ... Read more
3 Factors That Can Trip You Up While Reporting for Oncological Office Visits
Key: A review of history determines the type of code to use. Office visits are where the ... Read more
Liver:
Boost IA Chemotherapy Knowledge
Keeping time will guide your to the right code. The last thing you want to do with your l... Read more
Boost IA Chemotherapy Knowledge
Keeping time will guide your to the right code. The last thing you want to do with your l... Read more
You Be the Coder:
Tracking Down ICD-10-CM Codes for Ganglioneuroblastoma
Question: Recently, a patient came in with an aggressive case of ganglioneuroblastoma... Read more
Tracking Down ICD-10-CM Codes for Ganglioneuroblastoma
Question: Recently, a patient came in with an aggressive case of ganglioneuroblastoma... Read more
Radiation Oncology:
FAQs: Stay on Top of These Common Radiation Oncology Coding Blunders
A Comprehensive List from Pre-Radiology to Recovery If you are coding for oncology, you w... Read more
FAQs: Stay on Top of These Common Radiation Oncology Coding Blunders
A Comprehensive List from Pre-Radiology to Recovery If you are coding for oncology, you w... Read more
Practice Management:
No-Show Patients: A Step by Step Guide on Coding for Missed Appointments
Key: Code 99199 Can Be Confusing A patient is scheduled for a consultation but they never... Read more
No-Show Patients: A Step by Step Guide on Coding for Missed Appointments
Key: Code 99199 Can Be Confusing A patient is scheduled for a consultation but they never... Read more
Reader Question:
Pay Attention to the 5th Character for Mammograms
Question: Recently, a patient came into the oncologist’s office for a mammogram... Read more
Pay Attention to the 5th Character for Mammograms
Question: Recently, a patient came into the oncologist’s office for a mammogram... Read more
Reader Question:
Treatment Device Complexity Changes the Code You Use
Question: I am trying to code for treatment devices. The oncologist used a bolus spec... Read more
Treatment Device Complexity Changes the Code You Use
Question: I am trying to code for treatment devices. The oncologist used a bolus spec... Read more
Reader Question:
Understand Office Level Visits to Avoid Confusion
Question: I’m having a hard time understanding the difference between a level 4... Read more
Understand Office Level Visits to Avoid Confusion
Question: I’m having a hard time understanding the difference between a level 4... Read more
Reader Question:
Coding for Chemo Education Changes Depending on Your Audience
Question: At the practice I represent, we have a nurse practitioner who routinely has... Read more
Coding for Chemo Education Changes Depending on Your Audience
Question: At the practice I represent, we have a nurse practitioner who routinely has... Read more
Reader Question:
Two Noncontiguous Areas Means You Use and Intermediate Code
Question: I want to report the planning of radiation treatment but the codes are divi... Read more
Two Noncontiguous Areas Means You Use and Intermediate Code
Question: I want to report the planning of radiation treatment but the codes are divi... Read more
You Be the Coder:
Coding for Lymphoma? Be Specific!
Question: My provider recently had me code for a non-Hodgkin lymphoma that affected t... Read more
Coding for Lymphoma? Be Specific!
Question: My provider recently had me code for a non-Hodgkin lymphoma that affected t... Read more
MACRA:
Get Up to Speed for Oncology Quality Reporting with These FAQs
Embrace MIPS as PQRS wanes. If you think the expiring Physician Quality Reporting System ... Read more
Get Up to Speed for Oncology Quality Reporting with These FAQs
Embrace MIPS as PQRS wanes. If you think the expiring Physician Quality Reporting System ... Read more
MACRA:
Identify 19 Quality Measures for Your Oncology Practice
You’ll see familiar choices from PQRS. Make sure your oncology practice continues t... Read more
Identify 19 Quality Measures for Your Oncology Practice
You’ll see familiar choices from PQRS. Make sure your oncology practice continues t... Read more
Telehealth:
Always Ace Coding for Your E/M Telemedicine Services
Don’t forget POS code 02 on your telemedicine claims. With CPT® 2017, you&rsquo... Read more
Always Ace Coding for Your E/M Telemedicine Services
Don’t forget POS code 02 on your telemedicine claims. With CPT® 2017, you&rsquo... Read more
Reader Question:
Here's How to Bill for Overlapping Infusions
Question: I’ve been noticing a lot of situations where nurses schedule infusion... Read more
Here's How to Bill for Overlapping Infusions
Question: I’ve been noticing a lot of situations where nurses schedule infusion... Read more
You Be the Coder:
Heed These Important Reminders for Chemo Codes
Question: I am working with a provider who prescribed Avastin as part of a patient's ... Read more
Heed These Important Reminders for Chemo Codes
Question: I am working with a provider who prescribed Avastin as part of a patient's ... Read more
Chemotherapy Coding:
3 Scenarios Help You Select the Right Chemotherapy Code
From J codes to Q, you’ll be coding properly with these quick tips. Coding for chem... Read more
3 Scenarios Help You Select the Right Chemotherapy Code
From J codes to Q, you’ll be coding properly with these quick tips. Coding for chem... Read more
ICD-10:
Know How 'Z' Codes Can Enhance Your Claims
Yes, you can use these as primary diagnoses in certain circumstances. Whether using ICD-1... Read more
Know How 'Z' Codes Can Enhance Your Claims
Yes, you can use these as primary diagnoses in certain circumstances. Whether using ICD-1... Read more
Clip And Save:
Evaluate What Z Codes Can Do for You
Z codes are your keys to documenting chronic conditions or underlying physical or social c... Read more
Evaluate What Z Codes Can Do for You
Z codes are your keys to documenting chronic conditions or underlying physical or social c... Read more
Hospital Visits:
Avoid Being Among CMS' Subsequent Hospital Care Targets
Oncologists are in CMS’ hot seat for these services — don’t be a statist... Read more
Avoid Being Among CMS' Subsequent Hospital Care Targets
Oncologists are in CMS’ hot seat for these services — don’t be a statist... Read more
Reader Question:
You Can Flip-Flop Between 1995, 1997 E/M Guidelines
Question: I know I can choose either the 1995 or the 1997 documentation guidelines fo... Read more
You Can Flip-Flop Between 1995, 1997 E/M Guidelines
Question: I know I can choose either the 1995 or the 1997 documentation guidelines fo... Read more
Reader Question:
Can We Report Genetic Counseling?
Question: One of our patients presented with her husband — they are both surviv... Read more
Can We Report Genetic Counseling?
Question: One of our patients presented with her husband — they are both surviv... Read more
You Be the Coder:
Differentiate Excision, Biopsy
Question: After completing a self-audit, we discovered quite a few instances where sk... Read more
Differentiate Excision, Biopsy
Question: After completing a self-audit, we discovered quite a few instances where sk... Read more
Oncology Coding Errors:
Are Your Code Selections Among the Many Oncology Errors CMS Recently Found?
Use these expert tips to avoid making the same mistakes these practices made. According t... Read more
Are Your Code Selections Among the Many Oncology Errors CMS Recently Found?
Use these expert tips to avoid making the same mistakes these practices made. According t... Read more
Coding Compliance:
Multiple Auditors Are Reviewing Herceptin Claims — Are You At Risk?
Modifier JW could be your enemy instead of your friend for these claims. Oncology practic... Read more
Multiple Auditors Are Reviewing Herceptin Claims — Are You At Risk?
Modifier JW could be your enemy instead of your friend for these claims. Oncology practic... Read more
ICD-10:
Can You Fill in the ICD-10 Blanks in This Cancer Note?
Determine whether you know how to code these conditions with a quick quiz. When you&rsquo... Read more
Can You Fill in the ICD-10 Blanks in This Cancer Note?
Determine whether you know how to code these conditions with a quick quiz. When you&rsquo... Read more
ICD-10:
Answers to the ICD-10 Cancer Coding Quiz
Now that you’ve reviewed our sample note on page 28, check out these coding quiz ans... Read more
Answers to the ICD-10 Cancer Coding Quiz
Now that you’ve reviewed our sample note on page 28, check out these coding quiz ans... Read more
Reader Question:
Check with Payer for Dosimetry Claims
Question: We reported 12 units of 77300 and have the documentation to support it... Read more
Check with Payer for Dosimetry Claims
Question: We reported 12 units of 77300 and have the documentation to support it... Read more
Reader Question:
Know Cancer History Before Choosing PSA Dx
Question: We perform our own diagnostic PSA tests for patients who have benign prosta... Read more
Know Cancer History Before Choosing PSA Dx
Question: We perform our own diagnostic PSA tests for patients who have benign prosta... Read more
Reader Question:
Remember to Avoid Incident to In the Hospital
Question: Our oncologist and our PA evaluated a patient together in the hospital and ... Read more
Remember to Avoid Incident to In the Hospital
Question: Our oncologist and our PA evaluated a patient together in the hospital and ... Read more
Reader Question:
Stem Cell Harvest Code May Require Terminology Primer
Question: Our oncologist harvested stem cells from blood. Which code applies to this?... Read more
Stem Cell Harvest Code May Require Terminology Primer
Question: Our oncologist harvested stem cells from blood. Which code applies to this?... Read more
You Be the Coder:
Is Time on Your Side?
Question: Our oncologist discharged a patient from the hospital. He told us he spent ... Read more
Is Time on Your Side?
Question: Our oncologist discharged a patient from the hospital. He told us he spent ... Read more
Coding strategy:
5 Tips To Clean Up Your Cavity Chemo Coding
Locate the cavity and ignore time of infusion. Chemotherapy procedures are routine in ... Read more
5 Tips To Clean Up Your Cavity Chemo Coding
Locate the cavity and ignore time of infusion. Chemotherapy procedures are routine in ... Read more
2017 Update:
MPFS 2017: Are Specialties In Oncology Impacted?
Oncology practices escape an impact in 2017. You have been busy adapting to and implem... Read more
MPFS 2017: Are Specialties In Oncology Impacted?
Oncology practices escape an impact in 2017. You have been busy adapting to and implem... Read more
Coding Tips:
Three Simple Steps For Dosing In Clotting Factor Coding
Be precise for units; Medicare allows to bill for self-administration. Are you confused f... Read more
Three Simple Steps For Dosing In Clotting Factor Coding
Be precise for units; Medicare allows to bill for self-administration. Are you confused f... Read more
Hemophilia:
Basics You Can't Afford To Miss
Hemophilia is a bleeding disorder characterised by deficiency of clotting factor in the ... Read more
Basics You Can't Afford To Miss
Hemophilia is a bleeding disorder characterised by deficiency of clotting factor in the ... Read more
Reader Question:
Lower Third of Esophagus Implies Abdominal Segment
Question: What diagnosis code can we submit for malignancy in the lower third of th... Read more
Lower Third of Esophagus Implies Abdominal Segment
Question: What diagnosis code can we submit for malignancy in the lower third of th... Read more
Reader Question:
Check simple vs. complex for Radiation Therapy Planning
Question: How do we report the planning of radiation therapy for skeletal metastasi... Read more
Check simple vs. complex for Radiation Therapy Planning
Question: How do we report the planning of radiation therapy for skeletal metastasi... Read more
You Be the Coder:
Omit C9743 for Spacers
Question: Has the code C9743, for spacers, been deleted? How can we now bill for sp... Read more
Omit C9743 for Spacers
Question: Has the code C9743, for spacers, been deleted? How can we now bill for sp... Read more
2017 Update:
Learn to Implement New Screening And HCPCS Codes In 2017
Advance to 81539 in prostate screening, and add two new HCPCS S-codes. Prepare to welc... Read more
Learn to Implement New Screening And HCPCS Codes In 2017
Advance to 81539 in prostate screening, and add two new HCPCS S-codes. Prepare to welc... Read more
Know More About The 4Kscore Test
The 4Kscore Test measures the plasma levels of four different prostate-derived kallikrei... Read more
The 4Kscore Test measures the plasma levels of four different prostate-derived kallikrei... Read more
ICD-10-CM update:
Take This Quick Review of Diagnosis Codes for Key Hematological Conditions
Follow grade in MDS, remission and relapse in multiple myeloma, crisis in SCA. Begin t... Read more
Take This Quick Review of Diagnosis Codes for Key Hematological Conditions
Follow grade in MDS, remission and relapse in multiple myeloma, crisis in SCA. Begin t... Read more
Modifier Update:
2017: You Can No Longer Afford a Miss on the JW Modifier
Limit wasted drug policy to only single use vials and containers. The beginning of the... Read more
2017: You Can No Longer Afford a Miss on the JW Modifier
Limit wasted drug policy to only single use vials and containers. The beginning of the... Read more
Reader Question:
Find Cause for Feeding Difficulty
Question: In a patient with advanced carcinoma undergoing chemotherapy, our physici... Read more
Find Cause for Feeding Difficulty
Question: In a patient with advanced carcinoma undergoing chemotherapy, our physici... Read more
Reader Question:
Document Request for Consult
Question: A patient who was diagnosed with lymphoma and advised chemotherapy visite... Read more
Document Request for Consult
Question: A patient who was diagnosed with lymphoma and advised chemotherapy visite... Read more
Reader Question:
Turn To 99406 and 99407 for Smoking Cessation Counseling
Question: Are there any recent updates for reporting counseling services for cessat... Read more
Turn To 99406 and 99407 for Smoking Cessation Counseling
Question: Are there any recent updates for reporting counseling services for cessat... Read more
Reader Question:
Don't Ignore Overlap in Locations for Bladder Cancer
Question: Our physician documented a malignant cancer of the lateral and posterior ... Read more
Don't Ignore Overlap in Locations for Bladder Cancer
Question: Our physician documented a malignant cancer of the lateral and posterior ... Read more
You Be the Coder:
Code Olaratumab as Unlisted
Question: Our physician prescribed olaratumab for a patient diagnosed with soft tis... Read more
Code Olaratumab as Unlisted
Question: Our physician prescribed olaratumab for a patient diagnosed with soft tis... Read more
2017 Update:
Two Key CCI Updates Impact Your Radiation Oncology Coding in 2017
Edits dissolve for dosimetry and 3D planning; new ones apply to IMRT services. With the a... Read more
Two Key CCI Updates Impact Your Radiation Oncology Coding in 2017
Edits dissolve for dosimetry and 3D planning; new ones apply to IMRT services. With the a... Read more
ICD-10-CM Review:
Spot the Right Codes for Malignant Neoplasms in the Cord, Cauda, and Cranial Nerves
Cauda equina malignancy has defined code though not all in cranial nerves have specific ... Read more
Spot the Right Codes for Malignant Neoplasms in the Cord, Cauda, and Cranial Nerves
Cauda equina malignancy has defined code though not all in cranial nerves have specific ... Read more
E/M Coding:
Follow These Expert Tips For Perfect Prolonged Services Claims
Key: Watch the clock and add up all the time spent on one calendar day. Oncology practice... Read more
Follow These Expert Tips For Perfect Prolonged Services Claims
Key: Watch the clock and add up all the time spent on one calendar day. Oncology practice... Read more
Reader Question:
Meet Minimum INR Testing for Warfrin Dose Adjustments
Question: Our physician adjusted the warfarin dose for a patient during follow up in the... Read more
Meet Minimum INR Testing for Warfrin Dose Adjustments
Question: Our physician adjusted the warfarin dose for a patient during follow up in the... Read more
Reader Question:
Distinguish Biosimilar and Reference Filgrastim
Question: Our physician administered filgrastim has mentioned no other details for ... Read more
Distinguish Biosimilar and Reference Filgrastim
Question: Our physician administered filgrastim has mentioned no other details for ... Read more
Reader Question:
Target K13.4 for Oral Pyogenic Granuloma
Question: In a patient with a painless rapidly growing lesion in the oral cavity ne... Read more
Target K13.4 for Oral Pyogenic Granuloma
Question: In a patient with a painless rapidly growing lesion in the oral cavity ne... Read more
You Be the Coder:
Check the 48-hour Rule for Anti-emesis with Chemo
Question: Our physician prescribed oral chlorpromazine to a patient who presented f... Read more
Check the 48-hour Rule for Anti-emesis with Chemo
Question: Our physician prescribed oral chlorpromazine to a patient who presented f... Read more