Oncology & Hematology Coding Alert

Here are five important tips that will serve as a guide for your chemotherapy administration coding.

1. When your physician mixes more than one drugs in the same bag, you code for one administration for the bag of combined medication. Typically, these are non-chemotherapeutic agents mixed in the same bag. In general, chemotherapy drugs are not mixed with other medications in the same bag. Look for ‘intravenous piggy back’ in the procedure note. 

2. Verify only one initial administration code is billed per encounter. This initial code is governed by the primary reason for the encounter. “In a facility setting, the initial code is determined by the infusion hierarchy. (i.e. chemotherapeutic administrative services are primary to therapeutic , prophylactic and diagnostic administrative services, and therapeutic , prophylactic and diagnostic administrative services are primary to hydration administrative services,” says Kelly C. Loya, CPC-I, CHC, CPhT, CRMA, Director of Reimbursement and Advisory Services, Altegra Health, Inc.

3. Calculate time for each drug administered. Report add-on codes for every additional hour of infusion if the infusion interval is greater than 30 minutes beyond one hour increments. 

4. Do not ignore the type of substance administered.

5. Always read the parenthetical notes for chemotherapy administration codes.