Oncology & Hematology Coding Alert

Find out where Noridian and NGS fall on which drugs deserve chemo codes. One of the first things you probably learned as a medical oncology coder is that -chemo admin- codes aren't just for chemo admin. The reality is that properly applying 96401-96549 on your claims requires digging through multiple layers of CPT definitions and then analyzing how your payers apply those definitions in their policies. You-ll be on your way to claims success with this look at the CPT guidelines, two major Medicare players- interpretations, and what to do when your payer hasn't published its preferences. -Chemo Admin- Is More Than Meets the Eye CPT labels the chemotherapy administration code section (96401-96549) as -Chemotherapy and Other Highly Complex Drug or Highly Complex Biologic Agent Administration.- And the guidelines for that section spell out that -chemotherapy- in 96401-96549 includes -other highly complex drugs or other highly complex biologic [...]