oncology

  1. S

    Wiki Medical Oncology - Inpatient to Office

    Hi All, I am trying to work through something I came upon. Does anyone have resources on how to code/bill a registered inpatient who is transported to clinic to receive chemotherapy treatment? I had researched the CMS Claims Processing Manual and the only guidance is to utilize POS code 21 to...
  2. S

    Wiki Hydration vs TPD Infusion

    I need some help understanding this. There are two different examples I keep running into where I am not sure which would be the correct coding: sodium chloride 0.9% (NS) (BOLUS) injection 1000mL Start time 1340-1440 stopped ONE TIME IV Rate: 999mL/HR Indications of use: Hypovolemia *Should...
  3. P

    Wiki Mod 25 - 2 Providers, same specialty, same DOS

    Oncology practice: A pt is seen for an office visit by a provider and then has treatment therapy (chemo) by a different provider on the same day within the same practice and specialty. Would 25 modifier be added to the EM code for that day since it is two different providers?
  4. P

    Wiki MOD 25 - 2 Providers, Same Specialty, Same DOS

    Oncology practice: A pt is seen for an office visit by a provider and then has treatment therapy (chemo) by a different provider on the same day within the same practice and specialty. Would 25 modifier be added to the EM code for that day since it is two different providers?
  5. M

    Wiki Chemotherapy Drug Consults

    Our oncologists want to report consult codes (99446-99449) when they are compiling a treatment plan for chemotherapy for a patient. This is then sent to an oncology pharmacist who weighs in on if they think the course of treatment is appropriate. Is this the correct way to be reporting this...
  6. R

    Wiki Rad-Onc education

    Does anyone have any good sources for radiation oncology education, especially the new APM for rad/onc?
  7. C

    Wiki CHONC TEST PREP

    Hello, I am taking my CHONC in August. I am taking the class and have the study guides/practice exam. I also currently work in a Hematology Oncology practice. I have three questions: 1.) Is the specialty book for hematology oncology sold by the AAPC considered a reference book? I get mixed...
  8. suzannel

    Wiki Moderator Introduction!

    Hello everyone, I am your Oncology/Hematology moderator, and I wanted to go ahead and introduce myself. I'm Suzanne Burmeister, and I'm the editor of the Oncology and Hematology Coding Alert. I will be around to (hopefully) help with questions. I'm not always ready with immediate coding advice...
  9. T

    Wiki Radical Resection Help

    Hello, I am coding for an orthopedic oncologist that has performed a radical resection of a soft tissue sarcoma located in the right forearm that I am needing some advice on. The surgeon resected the sarcoma as well as part of the ulna that was underneath the sarcoma. My first thought was to...
  10. H

    Wiki cpc with outpatient, hospital and facility experience

    Nichole Morris, CPC NicholeHMorris85@gmail.com Medical Billing & Coding Accomplished professional with solid background in health care clinical operations, including medical billing and coding standards, financial policies, and medical record documentation. Expertise in insurance...
    • harrin
    • Thread
    • chemotherapy coding claim denials coder 1 denials prevention facility billing hospital coding infusion coding oncology revenue cycle management
    • Replies: 0
    • Forum: Resume Postings
  11. M

    Wiki Well-differentiated neuroendocrine (carcinoid) tumor?

    Hi everyone, I have a patient with a diagnosis of well-differentiated neuroendocrine tumor (carcinoid). In ICD-10, carcinoid is broken down into either benign or malignant, and the default for neuroendocrine is benign with a subterm of malignant poorly differentiated. Well-differentiated is not...
  12. C

    Wiki Oncology E/M Guidelines

    Hi there, Do oncologists use 1995 or 1997 guidelines for E/M coding? I'm guessing the answer is both, but I would like some more color on this if anyone could share. Thanks!
  13. L

    Wiki Identified Risk Factors in High Medical Decision Making for a Potential Malignancy

    There is a debate between the doctors and our department: An ultrasound was done and the patient has a 5 cm mass near her ovary. The MD is planning surgery to remove the mass, it is not known for certain whether or not the mass is benign or malignant. The MD believes that the mass is an...
    • Lanestor@gmail.com
    • Thread
    • high risk identified risk factor malignancy medical decision making oncology
    • Replies: 1
    • Forum: E/M
  14. A

    Wiki History of code for secondary cancer

    Do you use a "History of" code for a secondary cancer? For example, the patient is in for a 2017 followup visit. She was diagnosed in 2005 with breast cancer. In 2007 she had metastasis to her bones. Do you code Z08, Z85.3 or do you code Z08, Z85.3, Z85.830 (history of bone cancer)? I...
  15. A

    Wiki SEEKING ONCOLOGY BILLER/CODER in BERGEN COUNTY

    Large Bergen County multispecialty Medical Company seeks Radiation Oncology Biller. We have 3 oncology facilities and require an experienced motivated Biller/Coder to join our group! Excellent career opportunity! Very competitive salary! Send resume to: acastello@sovms.com for immediate...
  16. B

    Wiki Dcis

    Pt path report shows: low-grade duct carcinoma in situ, cribriform type with microcalcifications ER + PR +. My question is can DCIS be billed alone or does it need a secondary diagnosis? Any input would help.
  17. T

    Wiki E&M Hematology Oncology

    I am a new Auditor for E&M charges with Hematology Oncology practice. I am looking for any education sites or cheat sheets that anyone finds helpful. My email is tracy_mcpherson@aol.com. Thank you
  18. J

    Wiki Medication infusion and hydration billing

    Good evening, I would greatly appreciate any advice on the following topic: In the oncology department some patients receive hydration as well as their medication either due to dehydration, or due to the renal toxicity of the chemo. Hydration is given per the doctor's order. Previously our...
  19. J

    Wiki Infusion/hydration question

    Good afternoon, I would greatly appreciate any advice on the following topic: In the oncology department some patients receive hydration as well as their medication either due to dehydration, or due to the renal toxicity of the chemo. Hydration is given per the doctor's order. Previously our...
  20. A

    Wiki Coding recurrent bilateral lung cancer?

    I've gotten myself so confused, so I'm hoping you can help me. My case: In 2006, patient has left upper lobe squamous cell carcinoma. Treated with lobectomy and chemo. In 2015, patient returns with bilateral lesions that physician decides is a recurrence. This time right upper lobe and...
  21. C

    Wiki Coders Needed! Remote or in NJ Office

    We are looking for E/M and Oncology coders. Position: Onsite Full Time Permanent or Contract Medical Coder Location: Remote or In Jersey City Office CPC or equivalent. Minimum Experience: 2+ Years Multi-Specialty, EM, Wound Care Experience a plus. Please send your resume to...
  22. R

    Wiki Urgently looking for 10 Medical coders for Onsite and Remote coding positions

    Looking For Remote coders for Auditing Physicians Charts. Willing to travel when necessary. • Surgical oncology coder/Auditor for physician services with E&M coding. • Radiation oncology coder for physician services with E&M coding. Responsibilities: • Surgical coder with oncology experience...
  23. C

    Wiki Venofer and Ferrlicit infusion in a cancer center

    We are a hospital owned cancer center and starting 10/01/2015 CMS changed its LCD criteria for iron infusions. When I enter D64.81 with J1756 the LCD A54654 comes up that gives us the idea that iron infusions are only covered for patients that have tried and failed oral iron and have CKD, but...
  24. A

    Wiki Rad Onc Encounter Help

    I am new to CHONC world and don't have someone I'm training under, can anyone answer a question I have: If you are coding for an encounter for radiation therapy and they have a secondary malignancy that they are treating, do you still code the primary malignancy too? I was told that we don't...
  25. J

    Wiki Chemo Talk with RN - Education

    Up to now, we have done a one hour education "Chemo talk' with patients free of charge. My boss would like me to start billing for this service. My question is, What kind of documentation is needed to bill as a nurse visit - 99211? Is the same documentation needed to bill as an education service...
  26. J

    Wiki What's the best specialty?

    Hi What do you consider the best specialty? I was interested in oncology but someone with experience told me there aren't alot of oncology specific jobs. What's in demand? What keeps you busy? What do you think is the best paying specialty? Any info appreciated Judy
  27. M

    Wiki Oncology Dx

    Reaching out to oncology practices, we recently had a professional audit team come in to audit our records they stated diagnoses must be coded off of progress notes only, however in the past we have used pathology reports to confirm diagnoses. Can anyone else give us direction as to how you...
  28. C

    Wiki Radiation Oncology Billing Changes

    Where would I go to find all the Radiation Oncology Billing changes for 2016?
  29. T

    Wiki Comliance/billing for oncology

    I am new to oncology and questioning if a NPP can supervise chemo tx (96413) when the MD is not in the facility? Could we employee a FP cover this treatment wondering of there are board certification requirements for this treatment? thanks
  30. T

    Wiki Looking for Billing information for Radiation Oncology CPT 77427

    I am new to radiation oncology and would like to get some opinions on how you are billing the code 77427? The system that was put in place prior to my working in this facility is that it is automatically dropped after the 5th fraction and billed on that date. There is no "through" date. From...
  31. bproosow

    Wiki Active or History? Follow-up oncology visit with no further treatment

    We are having a heated debate here on this subject. Here is the scenario: Patient has cancer, let's just say colon cancer. Goes in for hemicolectomy. Surgery goes well, margins are clear, NED. Up to this point we are coding for the colon cancer. Patient goes for his first follow-up visit with...
  32. bproosow

    Wiki Coding for post-op oncology visit with no further treatment

    We are having a heated debate here on this subject. Here is the scenario: Patient has cancer, let's just say colon cancer. Goes in for hemicolectomy. Surgery goes well, margins are clear, NED. Up to this point we are coding for the colon cancer. Patient goes for his first follow-up visit...
  33. A

    Wiki Billing for Observation and chemotherapy on same DOS...Can we bill both?

    Can we bill for both oberservation (any observation cpt code) and chemotherapy administration (cpt code 96450) for same date of service? Any feedback is very much appreciated! :)
  34. E

    Wiki CPC-A in Durham, NC looking for experience

    I am a newly credentialed coder with a CPC-A located in Durham, NC. I have been in the workforce for over 30 years with experience in Hospitals in Hematology/Oncology, Podiatry, and Internal Medicine. I am looking for a job not only for the experience, but one that I can grow with. My main...
  35. D

    Wiki Outpatient VS Inpatient

    Could anyone tell me where I can find the rule where it says you can't treat a patient in the outpatient setting while in the hospital? We have patients that are being transported to our Radiation Oncology facility for therapy without discharging them from the hospital. That way they can then...
  36. N

    Wiki Oncology Coding

    I currentley am a CPC and have primary done E&M coding. Can anyone give me some information regarding oncology coding. I am looking for resources to further my knowledge. I would appreciate any help. Thanks
  37. D

    Wiki Oncology Office Visit then Chemo - mod 25?

    Need help with modifier 25. Here is the scenario: Patient see's the Oncologist to talk about whether its ok to have Chemo that same day. The Oncologist says yes and the patient is sent over to the Chemo Infusion Room. Question: Would the clinician attach modifier 25 to the LOS (i.e. 99214) for...
    • dhall50
    • Thread
    • chemotherapy infusion modifier usage office visit oncology
    • Replies: 1
    • Forum: Modifiers
  38. J

    Wiki Oncology coding audit-Macomb, MI

    I am looking for a certified coder that can audit a hospital owned oncology/hematology practice located in Macomb, Michigan. The audit is expected to last approximately six weeks. You will have access to the charts, Monday-Friday from 8am-4:30pm. If interested, please e-mail me at...
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