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Oncology & Hematology Coding Alert - 2024; Volume 26, Number 8
News You Can Use:
Know These 2025 ICD-10-CM Oncology Changes
And know why the changes are going to matter for Medicare billing. On Oct. 1, 2024, the ...
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E/M Coding:
Ask These 5 Questions, Accurately Calculate MDM Complexity Element
Hints: “Acute” may not be new, and “chronic” may not be specified by time. Assign...
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Revenue Cycle:
Hear From Those Affected by the Change Healthcare Outage
Reinforce your skills with paper-based claims. More than four months have passed since m...
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Reader Questions:
Pinpoint the Best Codes for This Breast Exam
Question: A 63-year-old patient presented for a diagnostic mammography exam with comp...
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Reader Questions:
Be Careful With Complexity for Undiagnosed Condition
Question: Does an undiagnosed new problem with uncertain diagnosis automatically mean...
Read more
Reader Questions:
Understand CMS MUE Process for Same DOS
Question: Can we charge 77295 for two different body parts if the plan is signed on t...
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You Be the Coder:
Don’t Assume Linkage in This Anemia/Cancer Encounter
Question: If the patient has lung cancer and anemia, can we assume the anemia is due ...
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Oncology & Hematology Coding Alert - 2024; Volume 26, Number 7
Genetic Testing:
Get the Answers to Your Frequently Asked Genetic Testing Questions
Here's how to make your way through the CPT® molecular pathology code set. “The geneti...
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Coding Quiz:
Correctly Code These Scenarios, Ace This Cancer Fatigue Quiz
Understand etiology and synonyms for accurate dx documentation. Cancer and fatigue go han...
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Reimbursement:
Find Your Way Through the Prior Authorization Maze
Hint: Don't forget to keep track of denials so you can troubleshoot your processes. Healt...
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Coding Quiz Answers:
Check Your Answers to Our Cancer Fatigue Coding Quiz
Don't forget to read inclusion terms carefully. Once you've answered the quiz questions o...
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Reader Questions:
Assign Codes and Responsibility for Code Choices
Question: Who is responsible for the final diagnosis used for an office/ outpatient e...
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Reader Questions:
Read Guidelines Closely for Breast Exam Documentation
Question: I have a radiology report stating the provider captured “ultrasound image...
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Reader Questions:
Let Purpose Determine Drug Administration Code Choice
Question: When a patient is receiving Lupron injections as part of their treatment fo...
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You Be the Coder:
Use This Tree for Correct Screening Mammography Coding
Question: If a patient is having a mammogram for a screening, you use the Z12.31. If ...
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Oncology & Hematology Coding Alert - 2024; Volume 26, Number 6
Drug Coding:
Understand These 4 Problems Before Submitting Drug Claims
And stay alert to these expert billing tips and examples. There are a lot of moving parts...
Read more
Modifiers:
Master Modifier 26, TC Coding With These 5 Tips
Hint: These modifiers can't separate every service. When your oncologist performs certai...
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Mythbuster:
Bust These Myths for Definitive SDoH Coding
Know the who, why, and what behind this critical new coding development. By now, most of ...
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Reader Questions:
Seek Out the Answer to This Separate Subspecialty Question
Question: I work for a fairly large oncology practice. We currently have medical onco...
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Reader Questions:
Code This Complication Dx Correctly
Question: If a patient suffers from an intra- or postoperative complication involving...
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Reader Questions:
Resolve the Right Way to Report This Tumor Resection
Question: What are the correct surgical and diagnosis codes to report for the follow...
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You Be the Coder:
Mend This Multiple Modifier Mess
Question: I have a denied claim for a patient who had 11 same-day lipoma removals. Th...
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Oncology & Hematology Coding Alert - 2024; Volume 26, Number 5
Infusion Coding:
Get the Answers to Your IAC Coding Questions
Good news: They're a whole lot easier to manage than their IV counterparts. It's easy to...
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E/M Coding:
Know These 4 Things to Bill 99211 Correctly
And learn these three reasons for not reporting it. When one of your clinical staff membe...
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Care Management:
Remember These 5 Rules for Successful TCM Documentation
Don't let intimidating, extensive guidelines get in the way of clear coding. When a patie...
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Reader Questions:
Be Careful With Complexity for Undiagnosed Condition
Question: Does an undiagnosed new problem with uncertain diagnosis automatically mean...
Read more
Reader Questions:
Beware Billing Multiple Radiation Therapy Units in This Scenario
Question: We billed one unit of 77290, 77318, and 77370, then billed again a week lat...
Read more
Reader Questions:
Clarify HIPAA Terminology
Question: What is the difference between “consent” and “authorization” in the...
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You Be the Coder:
Take 2 Steps to Code Testicular DLBCL
Question: What is the correct coding for testicular lymphoma? I have always been told...
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Oncology & Hematology Coding Alert - 2024; Volume 26, Number 4
Radiation Oncology:
Make Radiation Treatment Management Codes Count
But use this one code sparingly, if ever. There are many moving parts to radiation treatm...
Read more
Coding Quiz:
See If You Can Ace This Aftercare/Follow-Up Quiz
Hint: You can't interchange these terms. You may think that follow-up care and aftercare ...
Read more
Reimbursement:
Prevent Denials Before They Occur With These 4 Tips
Here's how to get all your documentation ducks in a row. If you've been experiencing an u...
Read more
Coding Quiz Answers:
Check Your Answers to Our Aftercare/Follow-Up Quiz
Don't forget the difference between antineoplastic therapy and surgery aftercare. Once ...
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Reader Questions:
Phone-In This E/M Encounter
Question: We had a patient present to the office for a follow-up appointment. When th...
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Reader Questions:
Differentiate Between These Codes to Report NETs
Question: One of our oncologists documented “left kidney, NET [neuroendocrine tumor...
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Reader Questions:
Follow This Advice for First-Listed Dx
Question: When a new patient comes in to establish care with one of our oncology prov...
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You Be the Coder:
Modify Your Understanding of These Delivery and Treatment Codes
Question: We were denied for billing G6002 and 77412 with place of service (POS) code...
Read more
Oncology & Hematology Coding Alert - 2024; Volume 26, Number 3
Care Management:
Know How To Navigate the New PIN Codes
And see how they compare with principal care management. When the Centers for Medicare &a...
Read more
ICD-10-CM Coding:
Get the Answers to Your Frequently Asked Neoplasm Table Questions
Check out these best practices to help you locate the right code every time. Oncology c...
Read more
Cybersecurity:
Take These Top 10 Tips to Protect Your Practice from Cyber Threats
Here's how to avoid going on a phishing expedition. Healthcare data breaches continue to ...
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How to Recognize Phishing
The Federal Trade Commission (FTC) defines phishing as “an unexpected email or text mess...
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Reader Questions:
Define Treatment Goal, Determine MDM Stability Calculation
Question: A patient with chronic pain presents for an evaluation and management (E/M)...
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Reader Questions:
Apply SDOH Codes for Underdosing and Financial Insecurity
Question: During a recent follow-up appointment with an established patient, the pati...
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Reader Questions:
Heed These Changes for Accurate HIPEC Coding
Question: How do I code hyperthermic intraperitoneal chemotherapy (HIPEC) after cytor...
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You Be the Coder:
Code for Context in This Adverse Chemo Effect Scenario
Question: A patient experiences throat pain from vomiting following chemotherapy. In ...
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Oncology & Hematology Coding Alert - 2024; Volume 26, Number 2
ICD-10-CM Coding:
Perfect Your Ovarian Cancer Coding With This Guide
Remember to keep these ovarian cyst codes handy, too. On the surface, coding for malignan...
Read more
Mythbuster:
Bust These 3 Myths for Accurate PSA Test Coding
Here's how to connect screens and diagnostic tests with medically appropriate dx. There a...
Read more
Practice Management:
Use This Expert Advice to Fine Tune Your CDI Process
Learn how to make your queries effective. If you've been neglecting your clinical docume...
Read more
Reader Questions:
Count Fractions the Medicare Way for Radiation Treatment Management
Question: I know that I should bill 77427 for five treatments. My question is this: ...
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Reader Questions:
Know How to Support These Immunodeficiency Codes
Question: What kind of support is needed to report D84.821? Do I need to see an immun...
Read more
Reader Questions:
Code This Lymph Node Path Report as Secondary
Question: One of our patients had known invasive ductal carcinoma of the breast and ...
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You Be the Coder:
Read This Add-On Descriptor to Code Sentinel Node Biopsy Correctly
Question: When one of our patients is sent for a sentinel node biopsy, the patient fi...
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Oncology & Hematology Coding Alert - 2024; Volume 26, Number 1
Diagnosis Focus:
Up the Ante on Your Anemia Coding
Here's how to navigate all the associated condition codes. Look up anemia in the ICD-10-...
Read more
Learn the 4 Main Forms of Anemia
According to the National Heart, Lung, and Blood Institute (NHLBI), there are four main ty...
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E/M Coding:
Follow 5 Tips to Solidify Inpatient Care Coding
Stay on top of the hospital E/M revisions. For the last year, you have been using a revis...
Read more
Modifiers:
Remember These Modifier 22 Dos and Don’ts
Beware of falling into the unlisted code trap. Consider this scenario: Your oncologist d...
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Reader Question:
Don’t Split These Chemo Components
Question: I bill for an outpatient service department at a local hospital, and when p...
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Reader Question:
Be Suspicious of Suspected Diagnoses
Question: Our providers are notorious for using “consistent with” and “likely...
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Reader Question:
Look to This LCD for Breast Reconstruction Necessity
Question: I billed 19318-RT for symmetry with 19361-LT for breast cancer and absence ...
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You Be the Coder:
Avoid Confusion With This Chemo Infusion Scenario
Question: Do I need a modifier to bill 96413 and +96368 together on the same date of ...
Read more
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