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Oncology & Hematology Coding Alert

Provenge:

Q2043 No Longer Includes Admin -- Claim Your $71

Published on Sun Jan 09, 2011

Don't miss the effective date for this change.Medicare offered some positive news for practices providing Provenge. The administration is now separately billable.History: In Transmittal 2254, dated July 8, 2011, CMS announced that Q2043 (Sipuleucel-t, minimum of 50 million autologous cd54+ cells activated with pap-gm-csf, including leukapheresis and all other preparatory procedures, per infusion) included all related services. The transmittal specifically listed administration as not separately billable.But a new transmittal changes all that by stating that you may report the administration separately.What's new: CMS rescinded Transmittal 2254 and replaced it with Transmittal 2239, dated Nov. 2, 2011, announced Roberta Buell, MBA, of onPoint Oncology in her Nov. 8, 2011, e-Reimbursement newsletter. The new transmittal has an effective date of June 30, 2011, and an implementation date of Aug. 8, 2011. You'll find it online at www.cms.gov/transmittals/downloads/R2339CP.pdf. Part of the revision is new language stating that "Q2043 is all-inclusive and represents [...]
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