Oncology & Hematology Coding Alert

CCI Update:

Q2043 Edits Abound in the Latest Round of CMS Bundles

Be sure to check the effective date for these edits.October 1, 2011, brings Correct Coding Initiative (CCI) 17.3 for physician coders. Be sure to check for Q2043 and 36xxx changes before you send in your next claim.Think Twice Before Pairing a Code With Q2043 The latest version of CCI adds 1,380 new edit pairs, according to Frank Cohen, principal and senior analyst for The Frank Cohen Group, LLC, in his NCCI 17.3 Update (available at www.frankcohen.com/html/access.html).  He notes that more than 12 percent of the edits involve Q2043 (Sipuleucel-t, minimum of 50 million autologous cd54+ cells activated with pap-gm-csf, including leukapheresis and all other preparatory procedures, per infusion). This long list may not be a surprise considering CMS's announcement that Q2043 is essentially a one-stop shop, including:Transportation process of collecting immune cells from a patient during a non-therapeutic leukapheresis procedure Subsequently sending the immune cells to the manufacturing facility [...]
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