OCD_coder
True Blue
Hello all~
I am needing some feedback from experienced coders of oncology. I bill profee mostly for 5 oncology clinics. I am struggling to help one clinic manager understand that we should be billing therapeutic infusion codes when we give Dacogen J0894.
I have tried to explain that it is just like when we give Zometa J3487. We should be coding from the 96365-96367 code set depending on other drugs that are given and for how long, because based on the HCPCS catagory this is a therapeutic drug, not a J9XXX chemotherapy drug.
She is insistant that because it is called a "chemotherapy" drug that we have to use the chemotherapy code set 96411-96417 code set.
Any feedback would be welcome and if you have more information than the CPT guidelines, it would be much appreciated.
Thank you.
I am needing some feedback from experienced coders of oncology. I bill profee mostly for 5 oncology clinics. I am struggling to help one clinic manager understand that we should be billing therapeutic infusion codes when we give Dacogen J0894.
I have tried to explain that it is just like when we give Zometa J3487. We should be coding from the 96365-96367 code set depending on other drugs that are given and for how long, because based on the HCPCS catagory this is a therapeutic drug, not a J9XXX chemotherapy drug.
She is insistant that because it is called a "chemotherapy" drug that we have to use the chemotherapy code set 96411-96417 code set.
Any feedback would be welcome and if you have more information than the CPT guidelines, it would be much appreciated.
Thank you.