Answer: A number of factors could be the source of your denials diagnosis coding confusion being the prime suspect.
Many oncology coders make the diagnosis coding mistake of treating therapeutic phlebotomy coding the same as chemotherapy treatment coding and they link the procedure to diagnosis codes for cancer. Check to make sure you're not making the same mistake.
Use one of the following diagnosis codes to meet the medical-necessity requirement for a phlebotomy:
238.4 Polycythemia vera
238.7 Other lymphatic and hematopoietic tissues
275.0 Disorders of iron metabolism
277.1 Disorders of porphyrin metabolism
285.0 Sideroblastic anemia
289.0 Polycythemia, secondary.
Something else you may want to watch out for when a patient undergoes a phlebotomy is the lack of sufficient documentation. Be sure the patient's record includes details of the condition being treated, the date of the service, and also documentation indicating either the patient's red blood cell mass or pre-phlebotomy hematocrit of greater than 60 percent. These details will substantiate your defense of a denial. |