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Oncology & Hematology Coding Alert

New IMRT Codes Top the List of 2002 CPT Changes for Oncology Practices
Oncology-related changes in CPT 2002 include a number of new codes for radia... Read more
Bone Biopsy and Aspiration Codes Moved to Surgery Section
Two of the more significant changes in CPT 2002 are the new codes for bone marrow biop... Read more
Observation Codes:
Usage Depends on Discharge and Admission
When billing for observation of a patient in a hospital (99218-99220... Read more
Reader Question:
Accessing a Port
Test your coding knowledge.  Determine how you would code this situ... Read more
Reader Question:
Medical Radiation
Question: May we bill for the technical component with 77300-77334? If so, what documentat... Read more
Reader Question:
Blood Draws
Question: Can a physician's office bill for a blood draw if it is done by a nurse employ... Read more
Reader Question:
Special Radiation Treatment Procedure
Question: What documentation is needed to bill 77470?New Jersey Subscriber  Answer: ... Read more
Isodose Plans:
How To Get Paid for More Than One
It is common for radiation oncologists to design multiple isodose plans (77305-77315) to... Read more
Determine When To Bill Supplies Separately
Reimbursement for chemotherapy administration is often barely enough to account for ... Read more
How Do You Choose? Modifier -21 Versus Prolonged Service Codes
Oncologists routinely spend extra time with patients and their families explaining dis... Read more
News Brief:
Oncology Diagnosis Codes Unchanged in 2002
The ICD-9 2002 includes no major changes for oncology practices. "The largest section of... Read more
News Brief:
Oncology Codes Unaffected by CCI Edits
The latest edits to Medicare's Correct Coding Initiative (CCI) will have little effect o... Read more
Reader Questions:
Neupogen and Leukine on the Same Day
Question: A Medicare patient was referred to us for an injection of Neupogen (J1441)... Read more
Reader Questions:
Stem Cell Transplants
Question: How should I code stem cell transplants involving donor leukocyte infusion (... Read more
You Be the Coder:
Multi-Use Vials
Test your coding knowledge.  Determine how you would code this situation be... Read more
New Source of Revenue for Potentially Life-Threatening Cases
As late as 1999, cancer patients admitted to an inpatient facility had to be unstable or... Read more
Bulletproof Pain Management Claims:
Follow AHRQ Guidelines
Pain management payment policies can be vague, and claims may lead to denials despite an... Read more
AHRQ Guidelines
The Agency for Healthcare Research and Quality (AHRQ) recommends physicians follow these... Read more
Bill 90780 and 90782 Separately From Chemotherapy
Claims that report the administration of support-care drugs -- whether the drugs ar... Read more
Reader Question:
Two Physicians
Question: Under what circumstances can two  physicians in the same practice bill for ... Read more
Reader Question:
Blood Draw Center
Question: We are a new outpatient cancer center and just started to draw blood. We are a... Read more
Reader Question:
Prolonged Service
Question: An oncologist in our practice admitted a patient for observation. He was told th... Read more
You Be the Coder:
Billing for Supplies
Test your coding knowledge.  Determine how you would code this situation before loo... Read more
New Codes for Expanded PET Scan Coverage Allow for Added Reimbursement
Medicare has issued 21 temporary codes (effective July 1, 2001) for reporting positr... Read more
Get Paid for Case Management With G0181 and G0182
When a patient is referred to a home-health agency or hospice, the oncologist is not exc... Read more
Same-Group Consults Require Detailed Documentation
Billing for a consultation (99241-99245) requested by a physician in the same group may ... Read more
Reader Question:
Non-Chemotherapy Injections
Question: I am having trouble getting reimbursed for 90784. Medicare states that it is not... Read more
Reader Question:
Chemotherapy Billing
Question: Can I bill 96408 (chemotherapy administration, intravenous; push technique) with... Read more
Reader Question:
Port Flush
Question: How can we get paid for port flushes? Can we bill for the supplies used for th... Read more
You Be the Coder:
Billing for Interleukin
Test your coding knowledge.  Determine how you would code this situation before loo... Read more
Use 96410 or E Codes for Infusion Pumps But Not Both
Oncologists are equipping more of their patients with ambulatory infusion pumps th... Read more
Get Paid for the Professional Component of Procedures
Many oncology practices assume that all procedures that office-based physicians order to... Read more
Use Modifier -Q5 for Substitute-Physician Services
If done correctly, oncologists who are not in the office can bill for services the pra... Read more
Reader Question:
Chemotherapy Drugs by Push Technique
Question: For chemotherapy drugs that must be "pushed" through an intravenous line, can ... Read more
Reader Question:
CT Scans
Question: If a radiation oncology practice owns a CT scanner, can the practice be reim... Read more
Reader Question:
Family Counseling
Question: Can we bill family counseling if the patient is not present?New Hampshire Subscr... Read more
Reader Question:
Office Consultation
Question: How should we code for an initial visit for a patient referred to us for colon... Read more
Reader Question:
77370 for Counseling
Question: Can we bill more than one special medical physics consult (77370) during a patie... Read more
You Be the Coder:
Bone-Marrow Transplant
Test your coding knowledge.  Determine how you would code this situation before l... Read more
Turn a Losing Proposition Into a Winner:
Know Which Oral Chemotherapy Drugs Are Reimbursed and Whom To Bill
Reimbursement for oral chemotherapy can be a losing proposition because Medica... Read more
Documentation Is Critical for Higher-Level Office Visits
Oncologists are losing money because they improperly code their more-than-routin... Read more
Some Commercial Carriers Still Reimburse 96545
Medicare has made code 96545 (provision of chemotherapy agent) virtually useless b... Read more
Reader Question:
Chemo Tray
Question: We have not been charging for supplies such as Huber needles, Buretols, ... Read more
Reader Question:
CT Scan Guidance
Question: When is it appropriate to bill 76370 for CT scan guidance for radiation trea... Read more
Reader Question:
Inpatient Chemotherapy
Question: When is it appropriate for a physician to bill for inpatient chemo... Read more
You Be the Coder:
Pump Refills
Test your coding knowledge.  Determine how you would code this situation befo... Read more
Determine When To Use Prolonged Service Codes for Extra Time
When an oncology-related visit takes longer than normal, codes +99354-+99355 used to desc... Read more
Reimbursement for Simulations Depends on Careful Documentation and Medical Necessity
The key to getting paid for simulations in radiation oncology no matter how many are perf... Read more
Use Code 36540 for Blood Collection but Not Port Flushes
When CPT 2001 included a new code for blood collection from ports, 36540 (collection of bl... Read more
News Flash:
New Drug, No Code
The FDA has approved a new anti-cancer drug for patients with chronic myeloid leukemia (CM... Read more
Reader Question:
Use Code 77370 Correctly
Question: Can more than one special medical physics consult, 77370 (special medical radiat... Read more
Reader Question:
Billing for Activase
Question: How should we bill 2 mg of Activase when the HCPCS code (and Medicare allowable)... Read more
Reader Question:
Coding for CT Scans Without Medical Necessity
Question: I am having problems getting reimbursed for a CT scan of the brain without and ... Read more
Reader Question:
Two Physicians
Question: When can two different physicians (in the same practice) bill for an inpatient... Read more
You Be the Coder:
Coding for an Elevated CA-125
Test your coding knowledge. Determine how you would code this situation before looking at... Read more
Correct Use of 77470 Ensures Pay Up of Extra Services for Radiation Oncologists
When a particularly difficult case of cancer is treated with a regimen of chemo-therapy an... Read more
Cut Through Coding Confusion for Hospital-based Chemotherapy Services
There are circumstances that require a patient to be placed in an outpatient hospital faci... Read more
Tips to Determine Confirmatory Consultations
Second opinions and confirmatory consults are not always synonymous. The same is true when... Read more
Correction Notice:
Ondansetron
In the February issue of Oncology Coding Alert, Key to Ondansetron Coverage Lies in Toxici... Read more
Reader Question:
RN Visits
Question: An RN in our radiation department sees patients before their treatment. She does... Read more
Reader Question:
Clinical Trial Reimbursement
Question: What are the new Medicare guidelines regarding patients on clinical trials?Virgi... Read more
Reader Question:
One Vial, Three Patients
Question: How do I code for chemotherapy drugs when one vial is used for several patient... Read more
You Be the Coder:
Use Code 77370 Correctly
Question: Can more than one special medical physics consult, 77370 (special medical radiat... Read more
Difference Between Diagnostic Mammograms and Screenings is Key to Accurate Coding
Determining whether a mammogram should be coded as screening or diagnostic depends on why ... Read more
Phlebotomies and Blood Draws:
Avoid Denials with Clear Definitions for Each
A patient has blood drawn at an oncology-hematology practice for routine diagnostic or ch... Read more
Coding Specificity is Crucial for CAT Scan Reimbursement
When coding computerized axial tomography (CAT) scans, coders need to be aware of what tes... Read more
Reader Question:
Special Treatment Procedure
Question: Can I code 77470 when performing a computerized tomography (CT) scan and 3 D sim... Read more
Reader Question:
Dosimetry
Question: What is the real date of service for basic dosimetry calculations, 77300? Is it ... Read more
Reader Question:
Adverse Effects
Question: What ICD-9 code do I use when a physician treats diarrhea post-chemotherapy? Geo... Read more
Reader Question:
Port Declotting
Question: If port declotting is done during the same visit as chemotherapy administration,... Read more
Reader Question:
Chemotherapy Administration
Question: We are unable to get paid by our Medicare carrier for chemotherapy administratio... Read more
You Be the Coder:
Billing for Lupron
Question: When is it appropriate to bill Lupron, J9217 (Leuprolide acetate [for depot susp... Read more
Bill E/M Service Separate to Chemotherapy Administration for Additional Reimbursement
Codes for evaluation and management (E/M) services, 99211-99215, and chemotherapy administ... Read more
Code Correctly for Consultations and Stop Losing Money
When an oncology physician sees a patient for the first time, erroneously coding the exam ... Read more
CCI Edits Update:
Denied E/M Services May Now Be Reimbursed
On Jan. 26, 2001, HCFA temporarily suspended version 6.3 of the National Correct Coding In... Read more
Stay Compliant:
Get Paid Properly for Pump Maintenance and Port Flushes
Too often, practices searching for codes to describe flushing and maintenance of portable ... Read more
Reader Question:
Supplies and Office Visits
Question: We have patients who come into our office to pick up a few weeks worth of suppli... Read more
Reader Question:
Supervising Physician
Question: We are a freestanding clinic next to a hospital. Our medical oncologist is a co... Read more
Reader Question:
Billing an Incomplete Test
Question: A patient comes in for a bone marrow test, but the doctor cannot reach the bone ... Read more
You Be the Coder:
Same-day Procedures and Office Visits
Question: How should I code phlebotomies or bone marrow procedures when they are performed... Read more
Key to Ondansetron Coverage Lies in Toxicity of Chemotherapy
Not all anti-emetics are alike, and they should not be coded as such. Ondansetron is a dru... Read more
Avoid Use of V Codes, Unless as Secondary Diagnosis
When coding for chemotherapy-related treatment, oncology practices should use either the... Read more
Insert:
Medicare Will Allow Expanded Coverage of FDG PET
Medicare has expanded coverage for 2-[fluorine-18]-fluoro-2-deoxy-d-glucose (FDG) positro... Read more
Reader Question:
Brachytherapy
Question: How do I code for the remote afterloading high-intensity brachytherapy (77781, 7... Read more
Reader Question:
Codes 96400-96549
Question: Is it appropriate to code for an evaluation and management (E/M) and intratheca... Read more
Reader Question:
Prostate Implant Program
Question: We are a private group of radiation oncologists starting up a prostate implant ... Read more
Reader Question:
Taxol Multidose Vial
Question: The J code for Taxol per 30 mg is J9265. The code was not changed when the drug... Read more
Reader Question:
Peripheral Stem Cell Collection
Question: What are the correct codes to use for peripheral stem cell collection, processin... Read more
Reader Question:
Billing Incident to
Question: Our oncologist is part of a large internal medicine group. In his absence, the n... Read more
You Be the Coder:
Baseline Echocardiograms
Question: I work for an oncology practice in central Illinois. We send chemotherapy patien... Read more
Increase Pay Up By Accurately Coding Treatments for Chronic Myeloid Leukemia
Care plan options for chronic myeloid leukemia (CML), 205.1, include commonly used procedu... Read more
PIN May Lead to Reimbursement for Chemotherapy Supplies
Most oncology practices absorb the cost of chemo-therapy supplies as inclusive with the ad... Read more
Use J9999 to Get Paid for Unclassified Drugs
The arsenal of anticancer drugs grows larger with every promising clinical trial. Unfortun... Read more
Reader Question:
Reciprocal Arrangements
Question: Our medical oncologist has two offices and is in our office two-and-a-half days ... Read more
Reader Question:
Provision of Chemotherapy Agent
Question: One of our oncologists would like to bill for the mixing of chemotherapy using 9... Read more
Reader Question:
Bone Marrow Aspirate
Question: After reviewing the fourth quarter CCI edits, I cannot determine how to bill for... Read more
Reader Question:
Code V67.1
Question: When is it appropriate to use V67.1? We have been told to use it when a patient ... Read more
You Be the Coder:
Herceptin Administration
Question: What code should I use for administering Herceptin?Utah SubscriberTest your codi... Read more
Available Years:  2001  2000  1999