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Oncology & Hematology Coding Alert

Transfusion Coding:
2 Essential Tips Will Improve Your Self-Donated Blood Claim Accuracy
Here is why you should have that ABN handy. Blood transfusion claims are easy if you can ... Read more
Diagnostic Tests:
Untie These Outpatient Diagnostic Test Supervision Requirements
Here's what personal versus direct supervision mean. For diagnostic imaging services, yo... Read more
Hematology:
Are You Aware of All These Hemophilia Types? Find Out
Here's what von Willebrand's factor means. In last month's Oncology Coding Alert, you le... Read more
Modifiers:
Follow This Essential Bilateral Surgery Indicator Advice
Plus, know exactly where to go to find your code's indicator. The process of appending la... Read more
Reader Questions:
Stay on Top of Rules for Telehealth to In-Person Transition Visits
Question: If a visit starts as telehealth and the patient then comes to the office for an ... Read more
Reader Questions:
Here’s How Diagnoses Can Help Your Claim
Question: A mother brings her daughter in for her four-year-old follow up after chemothera... Read more
Reader Questions:
Earn for Consultation Services
Question: Our physician offered consultation services to a patient who was in treatment wi... Read more
You Be the Coder:
Adapt to This PHE PPE Code
Question: What do you know about the new CPT® code for reporting additional practice expe... Read more
Hematology:
Bust These 4 Myths to Clarify How to Submit Perfect Clotting Factor Claims
Here's what you need to know about vials and units. Do you find yourself scratching your ... Read more
MPFS:
Brace Yourself: You May See Conversion Factor Cut by 10.6% Next year
Hint: Telehealth may expand into 2021. The Centers for Medicare & Medicaid Services... Read more
ICD-10-CM:
Are You Following This Excludes1 Note Definitive Rule? Find Out
Ask your MD if you don't know if a relation between two diagnoses exist. Diagnosis codi... Read more
Reader Questions:
LCD Diagnosis Reqs You Need to Know
Question: Does Medicare restrict coverage to only the diagnoses listed under the code's Lo... Read more
Reader Questions:
Master This Mediport Flush Scenario
Question: A patient with reticulolymphosarcoma in the inguinal lymph nodes presents for a ... Read more
Reader Questions:
Biopsy Alone Confirms Diagnosis of Malignant Bladder Tumor
Question: Our oncologist treated a patient for suspected bladder cancer. The diagnosis doc... Read more
Reader Questions:
Never Ignore Carrier State Confirmation
Question: Our physician has documented a family history of thalassemia carrier state. Do w... Read more
You Be the Coder:
Here’s How to Bill for Overlapping Infusions
Question: I've been noticing a lot of situations where nurses schedule infusions at overla... Read more
CPT® 2021 Update:
Flag These 5 Changes, Including Breast Reconstruction and Lung Biopsy Codes, to Help Your Oncology Claims Flourish Next Year
Find out what temporary code graduated to a regular CPT® code. You've likely been prepar... Read more
CPT® 2021:
Generate Perfect Genetic Testing Claims by Learning New Codes Now
Find out which code goes into effect October 1. Genetic testing gets overhauled for CPT®... Read more
E/M 2021:
Part 3: Manage Your MDM Component Expectations When 2021 Hits
Here's how the verbiage changes. This year, you've read all about the upcoming changes to... Read more
You Be the Coder:
Here’s How to Decide Between Malaise, Fatigue Dx
Question: One of our oncologists is capturing general complaints, like malaise and fatigue... Read more
Reader Question:
Here’s How Incident-to Guidelines Apply
Question: I reported 99211 for a nurse visit with a Medicare patient when our oncologist w... Read more
Reader Question:
Follow These Telehealth Documentation Reqs
Question: Due to the COVID-19 pandemic, our providers are performing mostly telehealth vid... Read more
Reader Questions:
Draw the Distinction Between Modifiers 52, 53
Question: What guidelines should I adhere to for a surgery cancelled midway because of hea... Read more
Back to Basics:
Strengthen Your Diagnosis Coding Skills for Common Oncology and Hematology Procedures
Learn what code to report for neoplasm related pain. Are you getting ready to take a cer... Read more
Coding Quiz:
Go In-Depth with Intralesional Corticosteroid Injections Claims
Hint: Count lesions, not injections for codes 11900 and 11901. If you get tangled up wit... Read more
Modifiers:
Call Attention to Cost-Sharing Waiving Using Modifier CS
Meet this specific set of criteria to waive cost-sharing on eligible services. As summer ... Read more
Coding Quiz Answers:
Eliminate 11900 Claim Errors by Following This Advice
Be accurate on units for HCPCS codes. Do you think you're a corticosteroid injection codi... Read more
Reader Questions:
For Donor Search and Planning, Use This Code
Question: Our oncologist is planning a transplant and looking for suitable donor of hemato... Read more
Reader Questions:
Highlight the Route for Ovarian Cyst Fluid Collection
Question: In a patient suspected to have ovarian tumor, our oncology obtained a sample of ... Read more
Reader Questions:
Underline the Cause for Screening Breast MRI
Question: Does Medicare pay for a screening breast MRI? Our physician is scheduling a brea... Read more
You Be the Coder:
Strengthen Your Therapeutic Phlebotomy Knowledge
Question: Our oncology surgeon did a therapeutic phlebotomy in a patient with polycythemia... Read more
ICD-10-CM Update:
Sickle-Cell and Hemolytic Anemia Diagnoses Highlight Your Upcoming Oncology/Hematology Changes
Always report the code with the highest level of specificity, based on documentation. Oc... Read more
Chemotherapy:
Identify Possible Errors in Your Intra-Arterial Claims — Before They Happen
Determine whether you have to own the pump to report 96425. If you assume that intra-ar... Read more
Billing:
Conquer These Medicare Billing Areas of Confusion With 4 Tips
Hint: Consider utilizing an MSP questionnaire. Successfully maneuvering through the Med... Read more
You Be the Coder:
Here's How to Code for Hearing Loss
Question: Our physician documented a diagnosis of mixed hearing loss in a patient who... Read more
Reader Questions:
How to Bill “Where Do We Go from Here” Visits
Question: If the patient is seen in the post-operative period for follow-up to discuss the... Read more
Reader Question:
Use This Code for Cushions and Foams
Question: Can we use code 77334 for cushions used during radiation therapy? Florida Subsc... Read more
Reader Questions:
Count Patches When Reporting Allergy Testing
Question: Our physician performed a patch test for allergy testing. How can we report this... Read more
ICD-10-CM:
Overlooking Your Cancer Diagnosis Codes? 2 Tricky Scenarios Test Your Skills
Here's how National Coverage Determination (“NCD”) guidelines can influence your code ... Read more
Case Study:
Capture the Right Codes for This Breast Cancer Counseling Encounter
Find out if you can bill for both a sick and preventive service during the same visit. If... Read more
Modifiers:
3 Tips Will Polish Up Your Modifier 78 Claims
If the MD performs an unplanned procedure during global period, avoid doing this. Your su... Read more
Reader Questions:
Understand Office Level Visits to Avoid Confusion
Question: I'm having a hard time understanding the difference between a level 4 and l... Read more
Reader Questions:
You Can Report 61020 with 96542
Question: How do we report when the physician performs an aspiration of CSF followed by ad... Read more
Reader Questions:
Take a Step Back for Debulking Services
Question: Patient with recurrent ovarian cancer with previous TAH/BSO undergoes new surger... Read more
You Be the Coder:
Pinpoint the Correct Lymphoma Code
Question: My provider recently had me code for a non-Hodgkin lymphoma that affected t... Read more
Hematology:
Here's How to Draw the Line Between Platelet and Blood Transfusions
Heads up: Bill one unit of 36430 for every transfusion. Platelet transfusion is not the s... Read more
E/M 2021:
Part 2: Here's How Established Office E/M Codes Will Shift in 2021
You shouldn't overlook history and exam. In “Part 1: Nix 99201 From Your New Patient Of... Read more
COVID-19:
Focus on Empathy When Connecting with Patients
Use these tips for showcasing bedside manner through telehealth. Even though using techn... Read more
Reader Question:
Do Not Submit 96368 for Infusions in Same Bag
Question: Our physician administered decadron and aloxi as an intravenous piggyback infusi... Read more
Reader Question:
Account for Multiple Respiratory Virus Tests
Question: Our in-house lab often gets orders for both SARS-CoV-2 testing and testing for I... Read more
Reader Question:
Confirm Trained Counselor for 96040
Question: Can we submit code 96040 for genetic counseling? Is it correct to submit E/M cod... Read more
You Be the Coder:
Physical Exam Requirements over Telehealth
Question: Due to the COVID-19 pandemic, our providers are performing mostly telehealth vid... Read more
FNA:
Confront 2 Challenges for Thyroid Nodule Fine Needle Claims
Here's what to do if your MD changes their imaging guidance method. Even in this era of s... Read more
E/M:
Follow These Expert Tips for Perfect 2020 Prolonged Services Claims
Key: Watch the clock and add up all time spent on one calendar day. With the PHE for COV... Read more
Documentation:
Keep Your Oncology Physician Queries Spick and Span Using These Tips
Read on for answers to your most frequently asked questions. Physician queries-and the an... Read more
Reader Question:
Do Not Forget Incident-To Services
Question: A patient diagnosed with reticulolymphosarcoma in the inguinal lymph nodes prese... Read more
You Be the Coder:
Here's How You Should Use Modifier CS
Question: What is modifier CS, and how should I use it? Texas Subscriber Answer:  ... Read more
Urgent:
Get Your Oncology Practice Up to Date with the Latest COVID-19 Coding Information
Find out why you should not use B34.2 as a diagnosis coding option. As you know, the 2019... Read more
Urgent:
Update Your Telehealth Coding Tactics with This Q&A
Don't assume this means you can use 99441-99443. With the outbreak of the novel coronav... Read more
Documentation:
5 Rules You Can Follow to Improve Your Oncology Documentation
Do not assume EMRs are flawless. Documentation compliance is as important as coding accu... Read more
Reader Question:
Take These Steps to Protect ePHI
Question: My practice plans to switch over to exclusively using electronic faxes, but befo... Read more
You Be the Coder:
Understand Services Inclusive in Preventive Care Visits
Question: A 50-year-old new male patient who had a strong family history of cancer, report... Read more
NCCI 26.0:
Be Certain You're Applying New Nerve Block, Excision, and Radiology Oncology Edits
Also, consider new 2020 E/M codes bundled into the regular office E/M codes. If you're ap... Read more
CERT:
Hematology/Oncology Practices Incurred $121 Million in Improper Payments
Insufficient documentation one of biggest errors found in latest report by CMS. As you ar... Read more
E/M 2021:
Part 1: Nix 99201 From Your New Patient Office E/M Codes in 2021
Tip: Look at either MDM or time to choose the appropriate outpatient code. You may not of... Read more
Reader Question:
Here's Your CHONC Optional Reference Guide
Question: I am going to sit for the exam this year. Under references it has: Optional... Read more
Reader Question:
Note These Levels of Appeals
Question: I submitted a claim to my region's Medicare Adminis­trative Contractor (MAC) fo... Read more
Reader Question:
Procedure Codes Include Preparation
Question: In a patient planned for a biopsy, our physician did an evaluation for about 20 ... Read more
You Be the Coder:
Draw the Line Between Observation and Admission
Question: Our oncologist saw a patient on 2/1/20 and then admitted her on 2/2/20. What cod... Read more
Urological Malignancy:
4 Tips Uncover How to Code Ultrasound Evaluation Of Urological Malignancy
Learn when to report ‘complete' vs ‘limited' evaluation. The extent of the evaluation... Read more
Anti-Emesis:
Ethically Maximize Your Bottom Line for Multiple Anti-Emesis Claims
Heads up: The 48-hour rule does not apply to Q0166 and Q0180. You may find yourself perpl... Read more
Medical Practice Tips:
10 Tips Will Help Your Oncology & Hematology Practice Work More Efficiently This Year
Make a formal error-checking process to keep your practice moving smoothly. You know each... Read more
Reader Question:
Fatigue and Asthenia are Not the Same
Question: In a patient with confirmed cancer, our oncologist documented fatigue. How can w... Read more
Reader Question:
Special Symbol Identifies Add-On Codes
Question: I noticed that some evaluation and management (E/M) codes have a plus symbol (+)... Read more
You Be the Coder:
GIST Diagnosis
Question: What is the appropriate code for GIST, and how do I find it? California Subscri... Read more
Diagnostic Tests:
3 Tips Protect Your Prostate Specific Antigen Testing Claims from Coding Mishaps
Heads up: CMS considers urological signs or symptoms payable diagnoses for PSA determinati... Read more
Advance Care:
End Your Confusion for Advance Care Planning Coding
Hint: Always document specifics in advance directives. In the Oncology & Hematol... Read more
Compliance:
5 Steps Prevent Incidental Protected Health Information Disclosures
Patients' data is often impermissibly disclosed due to a lack of staff training. Start th... Read more
Reader Question:
Look for Specific Code for HIT
Question: In a patient who was reported to have venous thrombosis, our physician has docum... Read more
Reader Question:
Check Class for HLA Testing
Question: Our provider does testing for antibodies to HLA in a patient to confirm the gene... Read more
You Be the Coder:
Modifier 25 With Venous Blood Specimen Collection and Labs
Question: Should I apply a modifier 25 onto an E/M visit code (992xx) when my oncolog... Read more
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