Oncology & Hematology Coding Alert
Study Pump Reporting Rules To Prevent a Deskful of Denials
Research is crucial before you enter the confusing world of reporting ambulatory pump services. Get started with these helpful resources.
When the Pennsylvania office of oncologist Mariette Austin, PhD, MD, began considering ambulatory pump use, coder Kelly Reibman, CPC, posted a note requesting information on the Oncology Coding Alert online discussion group at www.coding911.com. But she didn't stop there.
-I have done research on our local Medicare Web site, www.hgsa.com/professionals/index.shtml, and also our local DMERC carrier site, www.umd.nycpic.com/dmerc.html,- Reibman says. She also posted the question on the Pennsylvania Oncology Hematology Managers (POHMS) listserv and listened to a POHMS teleconference discussing the topic.
Professional organization sites can be another great resource. For example, many offices check out the American Society of Clinical Oncology site, www.ASCO.org, before starting ambulatory pump services.
Read the specific section for infusion pumps in the National Coverage Determinations Manual: Chapter 1, Part 4, Section 280.14. Go to www.cms.hhs.gov/coverage. From this home page, under -Coverage Database,- click on -National Coverage Determinations- (center of the page), says Tricia Katzberg, RHIT, CPC, CCS-P, with Bend Memorial Clinic in Bend, Ore.
From there, scroll down and click on -Infusion Pumps.- CMS has added a lot of new information, and if you scroll down to near the bottom, you can click on a link accessing claims information, she says.
Tip: Bring your nurses onboard -- a nurse Reibman works with -contacted the home health service that brings in the pumps for our patients to discuss the billing.-
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