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Oncology & Hematology Coding Alert

CPT® 2013:
38240-38243 Q&A Helps You Apply Updated Hematopoietic Progenitor Cell Codes
Stay alert for limited opportunities to report distinct E/M.When it comes to applying code... Read more
Chemotherapy:
96401-96549 Guidelines Aren't as New as They Appear -- Pinpoint the Key Revisions
Keep your infusion know-how current by reviewing a significant example update.When you rev... Read more
Vaccination:
90686 Isn't in Your Manual, But Don't Count It Out for Flu Vaccine
Trivalent and quadrivalent options are both available for 2013.Flu vaccines are constantly... Read more
ICD-10-CM:
282.62's Counterparts Specify Sickle Cell Crisis Types
Choose among 3 options when the code set changes.When sickle cell anemia results in crisis... Read more
CMS:
Report to Medicaid and Medicare? 2 Issues You Need to Know Now
Keep up with the latest on NDCs and the OIG Work Plan.Crossover areas for Medicare and Med... Read more
Payer Focus:
203.02 Is Required on Kyprolis Claims, Palmetto Says
Code J9999 is your drug code of choice until a more specific option is available.Attention... Read more
Reader Question:
POS Rule Change Has New Effective Date
Question: I've been expecting to see more information about CMS's place of service (POS) r... Read more
Reader Question:
96372 Admin Requires More Than Standing Order
Question: Is it OK to bill Medicare for injections performed based on lab results (a sort ... Read more
You Be the Coder:
Match Mesothelioma Case to Codes
Question: What are the proper codes for this encounter? The diagnosis is malignant pleural... Read more
CPT® 2013:
38243 Will Bring a New Option for HPC Boost Starting January 1
'Stem cell' makes way for 'hematopoietic progenitor' cell terminology.The CPT® 2013 ... Read more
E/M Update:
New E/M Language Acknowledges the Role of Nonphysicians
Check out the clarification explaining NPP specialties and subspecialties.Pick any E/M cod... Read more
Chest Coding:
32420-32422 Make Way for 4 New Thoracentesis and Pleural Drainage Codes in 2013
Wording changes clarify common aspiration coding questions.If you code for a group that pr... Read more
Venipuncture:
36400-36410 Will No Longer Specify Skill of Physician Only
But remember these codes still aren't for routine services.Expect to see a change to venip... Read more
ICD-10-CM:
D70.1 Will Offer a Chemotherapy-Specific Neutropenia Option
Start thinking in terms of 'agranulocytosis.'Once ICD-10-CM replaces ICD-9-CM in 2014, not... Read more
Reader Question:
96440 Is 1 of Many Codes With New Edits
Question: I saw an announcement about 230,000 new CCI edits. Are there any for infusions?C... Read more
Reader Question:
599.71 Offers 'Gross' Lesson
Question: Code 599.71 is for "gross" hematuria. What does that mean?Kansas SubscriberAnswe... Read more
You Be the Coder:
Seek Seminoma Encounter Codes
Question: What is the proper coding for this encounter? A patient presented for chemothera... Read more
ICD-10-CM R97.2 Takes the Place of 790.93 for Elevated PSA
Plus: Check out the latest update on the new code set's implementation date.   ... Read more
Drug Administration:
Ace Urologic Oncology With HCPCS, CPT®, and Payment Essentials
Remember to check your payer's self-administered drugs list to prevent denials.Coding for ... Read more
ICD-10-CM:
R97.2 Takes the Place of 790.93 for Elevated PSA
Plus: Check out the latest update on the new code set's implementation date.Mark Oct. 1, 2... Read more
Bone Mass Measurement:
77080 Has Multiple Medicare Hurdles That Could Trip Up Your Claims
Be prepared with these 5 tips on orders, frequency, coverage, and more.Prednisone may be h... Read more
BMM Coverage:
77080 Claim? Add These Resources to Your DXA Toolbox
Go local when the patient is still getting screenings.Certain cancers and treatments may l... Read more
Reader Question:
J9355 Isn't Subject to 'Wasted Drug' Payment
Question: Palmetto is doing a review of J9355 claims because people are reporting units in... Read more
Reader Question:
86386 Offers NMP22 Reporting Options
Question: We're a CLIA-waived lab performing the NMP22 test by Alere. How should we r... Read more
You Be the Coder:
Test Your Infusion Coding Mettle
Question: How should I report the following chemotherapy encounter for a patient with Ewin... Read more
CCI Update:
Correct Coding Initiative 18.2 Cleans Up Abdomen and Pelvis CT Coding
Confirm the reason for CT with PET before you code. If you code imaging services for your... Read more
News You Can Use:
Flip Through 5 ACA Changes That Could Affect Your Practice
Patients under private payers should see coverage for clinical trial standard-of-care cos... Read more
Clip and Save:
J2505 and 16 Other Top HCPCS Codes in 1 Simple Table
Pinpoint common non-chemotherapy codes at a glance. Whether your physician orders drugs t... Read more
ICD-10-CM:
D05 Range Promises 12 Future Breast Carcinoma in Situ Options
Plan ahead for increased category and anatomy requirements. ICD-10-CM has a long list of ... Read more
Reader Question:
J9033 Requires Extra Work for SNF Patient
Question: Why have we been getting denials for J9033 provided to SNF patients even though... Read more
Reader Question:
76604 Is an Unexpected Back Code
Question: Which ultrasound code applies for examining a mass on the back? Rhode Island Su... Read more
Reader Question:
61020 or 61070 May Describe Ommaya Aspiration
Question: What is the CPT® code for aspiration (via butterfly syringe) through the ... Read more
You Be the Coder:
Nab Proper Neuropathy Code
Question: What diagnosis codes would you use on this clinic follow-up visit? Patient has ... Read more
Infusion Coding 96413 and More:
Take the 3 Question Quiz for This Doxorubicin HCL Encounter
Bone up on documentation tips in the bonus round. Here's a quick chemotherapy infusion co... Read more
Urinalysis:
81001 Could Be Reduced to 81003 if Physician Order Doesn't Pass Muster
Be sure you're in the loop when the automated machine needs repairs.Proper documentation o... Read more
ICD-10-CM:
286.7 Includes Drug-Induced Deficiencies, But Don't Assume the Same for D68.4
Coagulation factor deficiency coding requires a look at the index.ICD-10-CM code D68.4 has... Read more
Reader Question:
83540 and 83550 Get the Green Light
Question: Will Medicare pay for both 83540 and 83550 on the same date of service?Georgia S... Read more
Reader Question:
Find Way to Calculate 50 Percent
Question: The physician states that "more than 40 minutes was spent counseling the patient... Read more
Reader Question:
76705, 76870, and 76882 Are Groin US Options
Question: Which CPT® code is used to report the ultrasound examination of a palpable... Read more
Reader Question:
Don't Make Diagnosis Assumptions
Question: In my coding classes, we learned that if the treating physician orders the test ... Read more
Reader Question:
99218-99220 Are OK on Day Before Admission
Question: I have trouble determining how to code professional encounter services for a pat... Read more
You Be the Coder:
996.1 for Extravasation?
Question: I need to report chemotherapy extravasation. Should I report 996.1 (mechanical c... Read more
Drug Coding:
Prepare in Advance for Potential 2013 HCPCS Updates
Factor these RiaSTAP code changes into your summer and winter plans. If you treat lymphoma... Read more
2013 Updates:
Get a Glimpse at the Future for CPT® and ICD-9-CM
E/M and bone marrow services could ring in the New Year with a makeover. Would you lik... Read more
ICD-10-CM:
V66.7 Meets Its Match With Z51.5
The new code set has its own V66.7, but its definition may surprise you.Coding for palliat... Read more
Lab Coding:
81002 or 81003? Here's How to Pinpoint the Proper Code
Understanding 'microscopy' will shore up your urinalysis coding.Even a straightforward tes... Read more
Reader Question:
233.0 Represents Lobular Carcinoma
Question: How should I report noninfiltrating lobular carcinoma?Connecticut Subscribe... Read more
Reader Question:
0280T Goes With 0279T for CellSearch
Question: We're researching CellSearch coding. Does 0280T describe the test plus interpret... Read more
Reader Question:
MPPR Offers Group Practices Some Good News
Question: Will you explain how the MPPR applies to imaging?Arizona SubscriberAnswer: For 2... Read more
Reader Question:
36415 Is Allowed for Blood Draw
Question: Can we bill insurance companies for a blood draw in the office that will be sent... Read more
You Be the Coder:
Port Flush and E/M: How Should You Code?
Question: I understand that I can't bill a port flush on the same date as chemotherapy inf... Read more
Infusions:
96360, +96361: Hydration in Focus for Oncology/Hematology Practices
Tackle 3 common areas of confusion. Questions about proper hydration coding are by no me... Read more
News You Can Use:
Put Place of Service Rule Change On Hold Until October 1
There may be more changes on the way. For CMS rules, keeping up with effective dates is a... Read more
ICD-10-CM:
157.8 Splits Into 'Other' and 'Overlapping Sites' Options for Pancreas
Check the guidelines before reporting ectopic tissue neoplasms.When documentation shows pa... Read more
Clip and Save:
170.4 or 170.5? Master the Long and the Short of Bone Neoplasm Codes
Take careful note of which code to turn to when the bone is NOS.Coding arm and leg bone ne... Read more
Medicare:
Follow 2 Key Takeaways for MSP Claims Success
For even more resources, check out MLN Matters SE1217.When Part B practices perform self-a... Read more
Reader Question:
287.3 and More Apply to This Case
Question: I'm coding for a patient with ITP, neutropenia, and macrocytic anemia. The physi... Read more
Reader Question:
80053 Requires All Listed Components
Question: The physician ordered a basic metabolic panel and hepatic function panel for a p... Read more
Reader Question:
99406 Matches to Symptomatic Patient
Question: How do we code for smoking cessation counseling? What are the criteria used to d... Read more
You Be the Coder:
Take the 3-Drug Coding Challenge
Question: The patient presented for a 2.21 mg subcutaneous Velcade injection, 20 mg of IV ... Read more
HCPCS:
Q2048, Q2049 Will Shake Up Your Liposomal Doxorubicin HCL Coding This Summer
CMS won't be using J9001 for Doxil once the change takes place in July. One of the side e... Read more
ICD-10-CM:
172.4 and C43.4 Differ in 1 Major Way for Melanoma Coding
Plus: Get the latest on the proposed implementation date.News flash: On April 9, Departmen... Read more
CCI Update:
Q2043 Edit Changes Promise Simpler Administration Reporting
If your claims fell victim to these erroneous bundles, now's the time to resubmit.Staying ... Read more
Denial Prevention:
Here's How to Sidestep 9 Top Claim Submission Errors
Get the front desk involved to help keep claims on track.What's the top tool in your arsen... Read more
Prostate Cancer:
Q2043 Expertise Is the Result of Good Detective Work
Take advantage of this strategy for catching diagnosis code requirements.Considering how o... Read more
Reader Question:
30901 Can Pair With E/M Code
Question: A patient experienced a nosebleed while in the office. The hematologist used pac... Read more
Reader Question:
96372 Represents Progesterone Administration
Question: What code should I bill for progesterone 200mg? Can you bill for the administrat... Read more
You Be the Coder:
Double Check Coding for Left and Right Lung
Question: If the physician documents that the patient has a primary neoplasm of the right ... Read more
Units of Service:
+96367: Frustrating Frequency Edit Is on the Way Out
Plus: Allowed Anzemet units take a dive. Here's why. If you're dealing with denials for se... Read more
CMS Update:
POS 34 Isn't Your Only Option for Hospice Patients
And watch this trap for in-office interpretations.CMS has announced a new place of service... Read more
ICD-10-CM:
V10.05 Swaps Places With Z85.030 for Personal History of Colon Neoplasm
Have you heard the news about the new code set's implementation date?The ICD-10-CM impleme... Read more
Reader Question:
10022 Specimen May Support Additional Service
Question: The physician performed a fine needle aspiration and then a needle biopsy of the... Read more
Reader Question:
96413 Usually Pairs With J1745
Question: We provide infusion services for patients being treated with Remicade. Should we... Read more
Reader Question:
96450 Doesn't Take Modifier 62
Question: An anesthesiologist worked with the oncologist on a case involving a lumbar punc... Read more
Reader Question:
J3301 Applies to Brand Name or Generic
Question: My doctor is using Kenalog 40 (NDC 0003029328) from Bristol Meyers Squibb. He sa... Read more
Reader Question:
E/M Guidelines Offer History Insight
Question: Our physician admitted someone as an initial inpatient, but couldn't get all her... Read more
You Be the Coder:
Code Metastatic Case With Breast Cancer History
Question: A patient with a history of breast cancer presents for treatment of newly diagno... Read more
2012 Update:
96360-96549: Apply These Guideline Revisions Today
These instruction changes aim to answer common infusion admin questions. At first glance, ... Read more
ICD-10-CM:
C54.- Will Require More Specifics Than Your Current Uterine Cancer Code
Have multiple primary neoplasms that don't touch? Follow this rule.The American Cancer Soc... Read more
5010:
Avoid This NOC Drug Code Denial Trigger
You need to know both 'what' and 'where' for success.Denials are occurring left and right ... Read more
E/M Update:
99218-99220 Add Typical Times for 2012
Initial and subsequent observation codes look a little more alike in 2012.Have you ever wi... Read more
Evaluation and Management:
3 Rules Help Keep Your E/M Claims Inside the Guidelines
Warning: Cloned notes aren't just a risk with EHR.If you're concerned your practice could ... Read more
Reader Question:
+96367 Now Has MUE of 3
Question: Why did we get a denial from Medicare for 4 units of +96367?New Mexico Subscribe... Read more
Reader Question:
96360 Isn't Right for KVO Fluid
Question: What does KVO mean in the phrase "continues to infuse at KVO prior to and during... Read more
Reader Question:
157.4 Is Appropriate for PNET
Question: Which diagnosis code describes PNET, Pancreatic neuroendocrine tumor, malignant?... Read more
Reader Question:
Base Birthday Rule on Month, Not Year
Question: I received a call from a patient's parent claiming that we didn't follow the bir... Read more
Reader Question:
153.8 Applies When Location Is Undetermined
Question: The oncologist's documentation confirms the pathologist's diagnosis of primary m... Read more
You Be the Coder:
Can MD Code This Hospital Case?
Question: The physician has recently performed an ommaya tap with chemo on a hospitalized ... Read more
Ondansetron Update:
Q0162 Takes the Place of Q0179 in 2012
Tap these resources on Medicare's oral anti-emetic policy.If your practice reports oral an... Read more
J8561:
Afinitor and Zortress Have a Common Code
As an oncology coder, you may be interested to know that HCPCS 2012 added J8561 (Everolimu... Read more
HCPCS Update:
J1561's New Look Reveals Trade Name and Admin Modifications
Plus: Check out more new codes for pain and fracture prevention.Changes to acetaminophen, ... Read more
ICD-10-CM:
V58.11 Finds Its Match in Z51.11
Immunotherapy finds a similarly clear counterpart in the new code set.The ICD-9-CM code fo... Read more
Clotting Factor Update:
J7180 and J7183 Bring New Options for Corifact and Wilate
Say so long to J7184 and Q2041.Double check the 2012 HCPCS codes before you report hemophi... Read more
Provider Requirement:
90460-90461 Show Importance of 'Qualified Health Care Professional' Definition
For accurate claims, distinguish these professionals from 'clinical staff.'The definition ... Read more
Reader Question:
G0364 or 38220 Depends on Payer
Question: For private payers, should I report G0364 or 38220 for aspiration and biopsy at ... Read more
Reader Question:
96372 Represents Office EpiPen Injection
Question: We used the EpiPen kit in the office on a patient who experienced an allerg... Read more
Reader Question:
280.x Lands on List for Iron Therapy NCD
Question: When a national coverage determination doesn't specify which codes to use, how d... Read more
You Be the Coder:
Are 3 Drugs in 1 Bag Concurrent?
Question: The patient presents for chemotherapy (57-minute infusion). Staff mixed three no... Read more
HCPCS Update:
J9043 Leads the Pack of New Chemotherapy Codes for 2012
The 2012 examples show which new drug code you're likely to pair with a push admin code.HC... Read more
HCPCS Tip:
Make the Most of Medicare's Unit Calculation Rules
While you're reviewing HCPCS 2012 updates with your practice, take a moment to go over Med... Read more
Table:
Q0179 Is Out, Q0162 Is In for 2012
See non-chemotherapy HCPCS changes at-a-glance.Whether your practice supplies Xgeva, Gamun... Read more
CPT® 2012:
38230 and 38231 Will Require Knowledge of Bone Marrow Donor
Change to global days offers new option for E/M reporting.Prepare to track down some donor... Read more
Provenge:
Q2043 No Longer Includes Admin -- Claim Your $71
Don't miss the effective date for this change.Medicare offered some positive news for prac... Read more
Breast Cancer:
J9035: CMS Avastin Coverage Is Safe for Now
Brush up on Medicare's off-label drug use policy.If you're worried that the FDA's decision... Read more
ICD-10-CM:
C64.- Will Require More Detail than Your Current Kidney Neoplasm Code
But you'll still need to look elsewhere to report renal pelvis neoplasms.When ICD-10-CM re... Read more
Reader Question:
J3300 and J3301 Both Connect to Kenalog Injection
Question:  How should I report an injection of Kenalog?South Carolina SubscriberAnswe... Read more
Reader Question:
182.0 Describes ESS
Question: How should I report endometrial stromal sarcoma?Nevada SubscriberAnswer: Th... Read more
Reader Question:
38220-59 Is Best Bet in This Case
Question: We want to be sure we're reporting 38220 correctly when the physician takes more... Read more
You Be the Coder:
36593 on Chemo Day: Yes or No?
Question: I know I can't report vascular access device flushing on the same date as chemot... Read more
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