Oncology & Hematology Coding Alert

In the meantime, avoid 36415 mistakes with this tip New oncology codes may be coming your way in 2007, judging from reports from the CPT Editorial Panel meeting in Las Vegas on June 9-10.
 
The final list of new CPT codes won't be out until this fall, and participants had to sign nondisclosure agreements before the meeting, but some eyewitnesses did mention details of the Panel's deliberations. Here's the scoop.
 
The Panel seemed interested in a proposal to create new codes for blood draws using PICC lines and other peripheral intravenous lines. A special work group gave this proposal the valuable notation that the -staff agrees,- making it more likely to go through, one participant says. Remember: Just because you have a specific code for a service doesn't mean you-ll receive separate reimbursement for it.
 
Caution: Many people mistakenly bill venipuncture code 36415 (Collection of venous blood by venipuncture) when the physician performs a PICC line blood draw, says Martin Neltner, president of oncology specialists Neltner Billing & Consulting in Independence, Ky.
 
For now, you should include the PICC blood draw as part of the evaluation and management service, but you can't use this service to raise your E/M levels, says Neltner, who proposed the change.
 
There should be at least two new codes, Neltner says: one for a device that goes inside the arm, similar to the PICC line, and one for an external catheter.
 
Other oncology proposals submitted to the committee include the following:

 - Revise -each additional hour- hydration, infusion, and injection codes 90761, 90766, 96415 and 96423 to reflect the amount of time nurses spend on them. The CPT Panel appeared reluctant to meddle with the new drug administration codes so soon after creating them, says
one attendee.

 - Allow nurses to report 90772 (Therapeutic, prophylactic, or diagnostic injection ...) even if a doctor wasn't present. Now the descriptor for this code says that if a doctor wasn't present you should bill 99211 (Office or other outpatient visit - that may not require the presence of a physician) -- which also requires physician supervision. The committee seemed concerned that 90772 is valued to include physician time and shouldn't be billed without it,  one witness says.

 - Allow providers to report IV push (90775) along with initial hydration code 90760. The Panel seemed to want to send this recommendation back to its special infusion workgroup for more consideration, attendees say.

 - Allow irrigation of an implanted venous access device (VAD) (96523) on the same date as a subcutaneous or intramuscular injection. This proposal also didn't seem to win favor with the Panel, attendees say