Oncology & Hematology Coding Alert
READER QUESTIONS :
CMS Says 52 and E/M Don't Mix
Published on Mon Jun 01, 2009
Question: If an E/M code requires three components, but we dont have documentation of an exam for a Medicare patient, should I append modifier 52? New Jersey Subscriber Answer: No. CMS states, CPT modifier 52 (reduced services) must not be used with an evaluation and management service. Medicare does not recognize modifier 52 for this purpose, in the Medicare Claims Processing Manual, Chapter 12, Section 30.6.1.B. If no CPT code describes the service as performed, the Manual instructs you to report 99499 (Unlisted evaluation and management service) and include a description of the service with a claim.
Other Articles in this issue of
Oncology & Hematology Coding Alert
- ICD-9 Update:
TakeYour Coding Specificity Up a NotchWith 7 2010 Changes
Tumor lysis syndrome is getting its own code -- will you know where to look? CMS [...] - Don't Let 2010's Thrombosis Codes Derail Your Claims
Acute vs. chronic will be 1 key to your 2010 ICD-9 choice. Whether you code [...] - You Be the Coder :
Recognize Proper Ommaya Code
Question: My practice is debating whether 61026, 96450, or 96542 is the most appropriate code [...] - Look Beyond New ICD-9 Code List for Clean Claims Clues
Watch for these 2 still-to-come notes and index changes. As long as the list of [...] - Get an Edge on 2010's All-New Embolism Coding
Expect upper extremity changes for Oct. 1. NEW: Pulmonary Embolism " 416.2 -- Chronic pulmonary embolism. [...] - READER QUESTIONS :
57155 Pay Is for Performance
Question: If the radiation oncologist attends a uterine tandem surgery placement so that he can [...] - READER QUESTIONS :
CMS Says 52 and E/M Don't Mix
Question: If an E/M code requires three components, but we dont have documentation of an [...] - READER QUESTIONS :
Vocab Boost: Understand Hyperfractionation
Question: What exactly is hyperfractionation? Pennsylvania Subscriber Answer: Hyperfractionation is any technique of radiation treatment [...] - READER QUESTIONS :
Match All Venofer Requirements
Question: My hematologists Venofer claims have been getting denied. Can you confirm the proper HCPCS [...]
View All
