Oncology & Hematology Coding Alert

Plus: Add a stack of J-codes to your toolkit to prevent 2009 denials For 2009, you-ll find lots of changes to HCPCS codes -- some additions, some deletions, and some drugs merely changing status. Look for several new J-code arrows to add to your quiver. They should make it easier to get paid when your oncologist or hematologist prescribes the latest treatments. Just Skip G0332 The hit to your office's budget is the deletion of code G0332 for both hospitals and freestanding centers. In 2006, CMS approved a temporary payment -- G0332 (Services for intravenous infusion of immunoglobulin prior to administration [this service is to be billed in conjunction with administration of immunoglobulin]) -- to cover the costs of acquiring and preparing an infusion of intravenous immune globulin (IVIG). The payment shored up the high-price IVIG during a shortage, says Tiffany Spencer, CPC, ACS-EM, a senior coding and billing consultant from North Carolina. Medicare reimburses about $60-$70 for the code, she says. Payment for G0332 was continued through 2008, but it comes to an end on Jan. 1. When you give a patient IVIG, your coding will be complete without G0332. For the nursing staff's work infusing these drugs, you should report 96365 (Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour). Add on code +96366 (... each additional hour) if the infusion lasts more than 90 minutes. These codes are also new for 2009. See "CPT Moves Infusion Code Set," page 11. Hidden trap: Stay away from 96413 (Chemotherapy administration, intravenous infusion technique; up to 1 hour, single or initial substance/drug) and +96415 (... each additional hour) when coding for IVIG. Those codes are for IV chemotherapy, monoclonal antibodies, and certain biological response modifiers only. Example: The physician administers 100 mg of Vivaglobin for a service that lasts less than an hour. In 2009: For this claim, you just report J1562 (Injection, immune globulin [Vivaglobin], 100 mg) and 96365, along with the appropriate ICD-9 code. In 2008: You would report J1562, 90765, the appropriate ICD-9 code, and G0332. Use These New Drug Codes If You Want to Get Paid Warning: The new crop of HCPCS codes, which take effect on Jan. 1, may give you d-j- vu. That's because you-ve seen some of the descriptors before. For example: HCPCS 2009 introduces new code J1459 (Injection, immune globulin [Privigen], intravenous, non-lyophilized [e.g., liquid], 500 mg), but deletes Q4097, which for 2008 used the same descriptor as new code J1459. "This is an instance where Privigen injections -graduated- from the Q-code section, which are temporary codes, to the J-codes, which are more permanent," says Heather Corcoran with CGH Billing in Louisville, Ky. "That's the only difference between the old and new [...]