Advanced Search

Oncology & Hematology Coding Alert

Reader Question :

Use This List for Unlisted Procedures

Published on Sun Jun 01, 2003

Question: What documentation must I have to report an unlisted-procedure code, such as 96549 (Unlisted chemotherapy procedure)? Minnesota Subscriber Answer: According to Cindy Parman, CPC, CPC-H, RCC, at Coding Strategies Inc., before you report this unlisted-procedure code, you must have the following:
a detailed description of the procedure performed
copies of articles in medical journals clinical trials, medical indications, etc.
documentation of the medical necessity of the procedure
time, effort and equipment required to perform the procedure
patient diagnosis, chief complaint (CC), presenting signs and symptoms
any concurrent problems requiring treatment or management
description of follow-up care and prognosis
cost savings from the procedure
comparison with existing procedure's reimbursement, including a comparison of time, effort, technical and professional work for both.  
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in Revenue Cycle Insider
  • 6 annual AAPC-approved CEUs
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more

Other Articles in this issue of

Oncology & Hematology Coding Alert

View All