Oncology & Hematology Coding Alert
Underline the Cause for Screening Breast MRI
Question: Does Medicare pay for a screening breast MRI? Our physician is scheduling a breast MRI in a BRCA2 positive patient. Massachusetts Subscriber Answer: You should confirm with Medicare if they cover the diagnosis Z15.01 (Genetic susceptibility to malignant neoplasm of breast) in support of medical need. At the present time, they will not pay for a screening breast MRI, so you have to establish that this is not screening. However, you cannot use a non-Z code because the patient currently does not appear to have an issue except for her BRCA status (unless she found a breast lump or something). Another option is using R97.8 (Other abnormal tumor markers) if you also have an abnormal tumor marker such as an elevated CA-15, ER status, etc. The BRCA test finds a gene that may increase the risk of cancer but is not a tumor marker.
Oncology & Hematology Coding Alert
- Back to Basics:
Strengthen Your Diagnosis Coding Skills for Common Oncology and Hematology Procedures
Learn what code to report for neoplasm related pain. Are you getting ready to take [...] - Coding Quiz:
Go In-Depth with Intralesional Corticosteroid Injections Claims
Hint: Count lesions, not injections for codes 11900 and 11901. If you get tangled up [...] - Modifiers:
Call Attention to Cost-Sharing Waiving Using Modifier CS
Meet this specific set of criteria to waive cost-sharing on eligible services. As summer trudges [...] - Coding Quiz Answers:
Eliminate 11900 Claim Errors by Following This Advice
Be accurate on units for HCPCS codes. Do you think you’re a corticosteroid injection coding [...] - You Be the Coder:
Strengthen Your Therapeutic Phlebotomy Knowledge
Question: Our oncology surgeon did a therapeutic phlebotomy in a patient with polycythemia. Should I [...] - Reader Questions:
Highlight the Route for Ovarian Cyst Fluid Collection
Question: In a patient suspected to have ovarian tumor, our oncology obtained a sample of [...] - Reader Questions:
For Donor Search and Planning, Use This Code
Question: Our oncologist is planning a transplant and looking for suitable donor of hematopoietic progenitor [...] - Reader Questions:
Underline the Cause for Screening Breast MRI
Question: Does Medicare pay for a screening breast MRI? Our physician is scheduling a breast [...]
