Part B Insider (Multispecialty) Coding Alert
In other news
As most E/M coders are aware, drug therapy requiring intensive monitoring for toxicity is considered a high risk management option in the table of risk, and applies to the physician’s work ensuring that patients’ drug levels stay at safe levels.
However, if you’re giving yourself extra points on the table of risk just because your patients are on drugs likely to cause toxicity (for instance, chemotherapy), you may want to re-check the doctor’s documentation to ensure he deserves the points.
“In order to receive ‘credit’ for drug therapy requiring intensive monitoring for toxicity, you must manage/monitor the drug,” Part B MAC Palmetto GBA says in a Feb. 6 E/M Weekly Tip. In other words, the patient merely being on the drug isn’t enough to qualify for the points—you must be the practitioner actually managing and monitoring it.
Palmetto expects to see “documentation in the medical record of drug levels obtained at appropriate levels” to demonstrate your work monitoring the patient to prevent toxicity, the payer says in its article “Drug Therapy Requiring Intensive Monitoring for Toxicity.”
To read more about Palmetto’s requirements, visit the MAC’s website at www.palmettogba.com.
Part B Insider (Multispecialty) Coding Alert
- Part B Coverage:
Medicare to Cover Lung Cancer Screening Scans
Patients with long history of smoking can now qualify for LDCT. Although CMS usually saves [...] - Part B Revenue Booster:
3 Facts You May Not Know About Incident to
And one that you probably do know—but aren’t following properly. As most practices are aware, [...] - Pulmonology Coding:
4 Tips Lead You to VQ Study Reimbursement Every Time
Look for references to “inhalation” or “gases” for vent study documentation. When your pulmonologist attends [...] - Get to Know the VQ Scan Specifics
A lung ventilation/perfusion scan, or VQ scan, is a test that helps a pulmonologist measure [...] - Reader Question:
Be Ready to Send Documentation With Unlisted Code
Question: I’ve read that we should report 64999 for radiofrequency of the lumbar sympathetic chain, but [...] - Part B Coding Coach:
Achieve Sigmoidoscopy Accuracy With 3 Quick Tips
Knowing the correct situations to report control of bleeding will help avoid denials. With all [...] - Physician Notes:
This MAC Updates Its Modifier 51 Rules--Reminding You NOT to Use It
Plus: Don’t take ‘credit’ for toxic drug management if you aren’t monitoring it. Both CPT® [...] - In other news
As most E/M coders are aware, drug therapy requiring intensive monitoring for toxicity is considered [...]
