Oncology & Hematology Coding Alert
Biopsies:
5 Q&As; Will Eliminate Integumentary Biopsy Coding Mishaps
Base your CPT® code on lesion size, location, and malignancy. Whenever your oncologist s... Read more
5 Q&As; Will Eliminate Integumentary Biopsy Coding Mishaps
Base your CPT® code on lesion size, location, and malignancy. Whenever your oncologist s... Read more
Coding Quiz:
Are You a Brain Tumor Diagnosis Coding Expert? Find Out.
Hint: Anatomical location is your key to the right code. Ostensibly simple, brain tumor o... Read more
Are You a Brain Tumor Diagnosis Coding Expert? Find Out.
Hint: Anatomical location is your key to the right code. Ostensibly simple, brain tumor o... Read more
MIPS:
Take Note of Changes to MIPS Performance Thresholds and More
Avoiding negative payment adjustments may become more difficult. As part of the Medicare ... Read more
Take Note of Changes to MIPS Performance Thresholds and More
Avoiding negative payment adjustments may become more difficult. As part of the Medicare ... Read more
Coding Quiz Answers:
Here's Why You Need to Get Specific for Brain Tumor Coding
Discover what to do when your physician doesn't document the site. Are you an expert at r... Read more
Here's Why You Need to Get Specific for Brain Tumor Coding
Discover what to do when your physician doesn't document the site. Are you an expert at r... Read more
Reader Question:
Don't Stray Far from Dictation Report Diagnoses
Question: If you've got a report without a diagnosis that meets the CPT® code's Local Cov... Read more
Don't Stray Far from Dictation Report Diagnoses
Question: If you've got a report without a diagnosis that meets the CPT® code's Local Cov... Read more
Reader Question:
Learn How to Determine E/M Level In This Special Scenario
Question: We have a new patient who is deaf, and his family member came to his appointment... Read more
Learn How to Determine E/M Level In This Special Scenario
Question: We have a new patient who is deaf, and his family member came to his appointment... Read more
You Be the Coder:
Earn for Each Component of Chemotherapy
Question: A patient received Cisplatin 100 mg for 2 hours, Taxotere 120 mg for 1 hour 1 mi... Read more
Earn for Each Component of Chemotherapy
Question: A patient received Cisplatin 100 mg for 2 hours, Taxotere 120 mg for 1 hour 1 mi... Read more
Chemotherapy:
Think You Are an Expert Chemo Coder? Find Out by Attempting This 3 Scenario Challenge
Highlight these important takeaways and policy tips. Coding for chemotherapy involves muc... Read more
Think You Are an Expert Chemo Coder? Find Out by Attempting This 3 Scenario Challenge
Highlight these important takeaways and policy tips. Coding for chemotherapy involves muc... Read more
Screening Refresher:
G0472: Do Not Miss Payment for Hepatitis C Screening
Reserve repeat annual screening only for high risk patients. When your physician screens ... Read more
G0472: Do Not Miss Payment for Hepatitis C Screening
Reserve repeat annual screening only for high risk patients. When your physician screens ... Read more
Advance Care:
Here's How to Find Your Way Through the Advance Care Planning Coding Maze
Avoid costly mistakes by following the time and documentation requirements. If you've got... Read more
Here's How to Find Your Way Through the Advance Care Planning Coding Maze
Avoid costly mistakes by following the time and documentation requirements. If you've got... Read more
Reader Question:
Lower Third of Esophagus Implies Abdominal Segment
Question: What diagnosis code can we submit for malignancy in the lower third of the esoph... Read more
Lower Third of Esophagus Implies Abdominal Segment
Question: What diagnosis code can we submit for malignancy in the lower third of the esoph... Read more
Reader Question:
Avoid Adding Up ER and Office Visits
Question: If a patient was seen for an office visit (99214) first and then later on the sa... Read more
Avoid Adding Up ER and Office Visits
Question: If a patient was seen for an office visit (99214) first and then later on the sa... Read more
You Be the Coder:
Simple vs. Complex for Radiation Therapy Planning
Question: How do we report the planning of radiation therapy for skeletal metastasis? New... Read more
Simple vs. Complex for Radiation Therapy Planning
Question: How do we report the planning of radiation therapy for skeletal metastasis? New... Read more
CPT® 2020 Update:
Sort Through Dozens of New Diagnostic, Pathology Additions Before Jan. 1 Hits
If you're using patient portals, you'll rejoice at the inclusion of these new online codes... Read more
Sort Through Dozens of New Diagnostic, Pathology Additions Before Jan. 1 Hits
If you're using patient portals, you'll rejoice at the inclusion of these new online codes... Read more
E/M Coding:
CPT® Panel Planning Big Changes for 2021 E/Ms
If you're fond of 99201, get ready to be heartbroken. Outpatient evaluation and managemen... Read more
CPT® Panel Planning Big Changes for 2021 E/Ms
If you're fond of 99201, get ready to be heartbroken. Outpatient evaluation and managemen... Read more
Reader Question:
These Procedure Codes Include Preparation
Question: In a patient planned for a biopsy, our physician did an evaluation for about 20 ... Read more
These Procedure Codes Include Preparation
Question: In a patient planned for a biopsy, our physician did an evaluation for about 20 ... Read more
Reader Question:
Submit 1 unit of J3430 for Every mg of Vitamin K
Question: In a patient with bleeding disorder, our physician administered an injection of ... Read more
Submit 1 unit of J3430 for Every mg of Vitamin K
Question: In a patient with bleeding disorder, our physician administered an injection of ... Read more
You Be the Coder:
Watch the Bundles Before You Report Modified Barium Swallow
Question: What is a modified barium swallow? Is there a specific code for reporting servic... Read more
Watch the Bundles Before You Report Modified Barium Swallow
Question: What is a modified barium swallow? Is there a specific code for reporting servic... Read more
Chemotherapy:
4 Tips Will Help Improve Your IA Chemotherapy Coding Accuracy
Keep a close eye on infusion times. When you're staring at a claim for a liver cancer pat... Read more
4 Tips Will Help Improve Your IA Chemotherapy Coding Accuracy
Keep a close eye on infusion times. When you're staring at a claim for a liver cancer pat... Read more
Transitional Care:
7 Questions Will Prevent TCM Coding Errors Before They Occur
Medication reconciliation and supervision must occur no later than date of face-to-face vi... Read more
7 Questions Will Prevent TCM Coding Errors Before They Occur
Medication reconciliation and supervision must occur no later than date of face-to-face vi... Read more
Practice Management:
Cloned Notes Can Lead to Inaccuracies — and Trouble
Keep copying and pasting to a minimum. Advancements and enhancements in technology like e... Read more
Cloned Notes Can Lead to Inaccuracies — and Trouble
Keep copying and pasting to a minimum. Advancements and enhancements in technology like e... Read more
Reader Question:
Lower Third of Esophagus Implies Abdominal Segment
Question: What diagnosis code can we submit for malignancy in the lower third of the ... Read more
Lower Third of Esophagus Implies Abdominal Segment
Question: What diagnosis code can we submit for malignancy in the lower third of the ... Read more
Reader Question:
Link Revisions to the EMR or EHR Appropriately
Question: When we see that documentation doesn't match a code choice, we usually go b... Read more
Link Revisions to the EMR or EHR Appropriately
Question: When we see that documentation doesn't match a code choice, we usually go b... Read more
Reader Question:
Target Q9981 for Rolapitant
Question: How can we code for rolapitant? Was there a recent update on coding for thi... Read more
Target Q9981 for Rolapitant
Question: How can we code for rolapitant? Was there a recent update on coding for thi... Read more
You Be the Coder:
Manage Multiple Diagnoses
Question: We saw a patient who ended up having more than 12 diagnoses. Is there a way to r... Read more
Manage Multiple Diagnoses
Question: We saw a patient who ended up having more than 12 diagnoses. Is there a way to r... Read more
2020 ICD-10-CM Updates:
Personal History and Breast Lump Quadrants Highlight 7 Oncology Coding Changes
Plus, you'll have new symptom codes to add to your coding cache. You've got a new list of... Read more
Personal History and Breast Lump Quadrants Highlight 7 Oncology Coding Changes
Plus, you'll have new symptom codes to add to your coding cache. You've got a new list of... Read more
E/M:
Encounters Alone Do Not Determine New vs. Established
Tip: Different specialties may introduce exceptions. Your practice may report for new as ... Read more
Encounters Alone Do Not Determine New vs. Established
Tip: Different specialties may introduce exceptions. Your practice may report for new as ... Read more
Practice Management:
Know the Ins and Outs for These Special Services
Don't let money walk out the door in situations where the coding guidance may be hazy. Yo... Read more
Know the Ins and Outs for These Special Services
Don't let money walk out the door in situations where the coding guidance may be hazy. Yo... Read more
Reader Question:
Pay Attention to the 5th Character for Mammograms
Question: Recently, a patient came into the oncologist's office for a mammogram to have a ... Read more
Pay Attention to the 5th Character for Mammograms
Question: Recently, a patient came into the oncologist's office for a mammogram to have a ... Read more
Reader Question:
Turn to 77334 for Cushions and Foams
Question: Can we use code 77334 for cushions used during radiation therapy? Florida Subsc... Read more
Turn to 77334 for Cushions and Foams
Question: Can we use code 77334 for cushions used during radiation therapy? Florida Subsc... Read more
You Be the Coder:
Confirm Non-ESRD Use for J0881
Question: A patient who is on chemotherapy treatment for lymphoma, presents for a weekly i... Read more
Confirm Non-ESRD Use for J0881
Question: A patient who is on chemotherapy treatment for lymphoma, presents for a weekly i... Read more
Radiation Oncology:
Analyze 4 Common FAQ Answers to Avoid Radiology Oncology Coding Errors
Here's the difference between basic dosimetry and special dosimetry. Oncology coding can ... Read more
Analyze 4 Common FAQ Answers to Avoid Radiology Oncology Coding Errors
Here's the difference between basic dosimetry and special dosimetry. Oncology coding can ... Read more
MythBusters:
Shatter These 4 Myths to Achieve Aftercare Coding Perfection
Highlight the codes you'll most often see in your oncology practice. When you think of fo... Read more
Shatter These 4 Myths to Achieve Aftercare Coding Perfection
Highlight the codes you'll most often see in your oncology practice. When you think of fo... Read more
Practice Management:
No-Show Patients? Follow This Step by Step Guide on Coding for Missed Appointments
Here's why 99199 can be confusing. A patient is scheduled for a consultation but they nev... Read more
No-Show Patients? Follow This Step by Step Guide on Coding for Missed Appointments
Here's why 99199 can be confusing. A patient is scheduled for a consultation but they nev... Read more
Reader Question:
Too Many Modifiers? Check Modifier 99
Question: We have a small practice in a designated health professional shortage area (HP... Read more
Too Many Modifiers? Check Modifier 99
Question: We have a small practice in a designated health professional shortage area (HP... Read more
Reader Question:
Catheter Cost Is Included In 51702
Question: For a patient with a urinary catheter, can we bill for the Foley itself when rep... Read more
Catheter Cost Is Included In 51702
Question: For a patient with a urinary catheter, can we bill for the Foley itself when rep... Read more
You Be the Coder:
Capture Colorectal Cancer Screenings
Question: Our physician often does colonoscopy, barium enema, occult blood tests, and othe... Read more
Capture Colorectal Cancer Screenings
Question: Our physician often does colonoscopy, barium enema, occult blood tests, and othe... Read more
Coding Strategy:
Here's How to Take the Initiative Perfecting Your Malignant Melanoma Claims
Untangle your ICD-10 coding options by specifying location and laterality. Are you puzzle... Read more
Here's How to Take the Initiative Perfecting Your Malignant Melanoma Claims
Untangle your ICD-10 coding options by specifying location and laterality. Are you puzzle... Read more
Chemotherapy:
Handle Multiple Substances, Concurrent Hydration Chemotherapy Claims Like a Pro
Here's why you need to keep an eye on total infusion hours. Mastering multiple infusions ... Read more
Handle Multiple Substances, Concurrent Hydration Chemotherapy Claims Like a Pro
Here's why you need to keep an eye on total infusion hours. Mastering multiple infusions ... Read more
E/M Coding:
Shore Up Your Claims by Using CBR Insight
Tip: Turnaround E/M blunders with benchmarking numbers. If you feel like Medicare claims ... Read more
Shore Up Your Claims by Using CBR Insight
Tip: Turnaround E/M blunders with benchmarking numbers. If you feel like Medicare claims ... Read more
Reader Question:
Too Many Modifiers? Check Modifier 99
Question: We have a small practice in a designated health professional shortage area (HPSA... Read more
Too Many Modifiers? Check Modifier 99
Question: We have a small practice in a designated health professional shortage area (HPSA... Read more
You Be the Coder:
Follow-up Care is Key to Xofigo Coding
Question: In a patient with advanced resistant prostate cancer, our oncologist administere... Read more
Follow-up Care is Key to Xofigo Coding
Question: In a patient with advanced resistant prostate cancer, our oncologist administere... Read more
Stem Cell Transplants:
Defining Origin/Donor Will Help You Avoid Making Stem Cell Transplant Coding Mishaps
Should you report a code for every stem cell collection session? Find out. When onc... Read more
Defining Origin/Donor Will Help You Avoid Making Stem Cell Transplant Coding Mishaps
Should you report a code for every stem cell collection session? Find out. When onc... Read more
Biopsy:
3 Tips Draw the Line Between FNA and PNB Procedures
Watch out, mistakes will cost $78 per procedure. When the oncologist merely documents “... Read more
3 Tips Draw the Line Between FNA and PNB Procedures
Watch out, mistakes will cost $78 per procedure. When the oncologist merely documents “... Read more
Appeals:
Navigate the Medicare Part A and B Appeals Process with Ease
Dig into the 5 levels of the appeals process. You submit a claim to your Medicare Adminis... Read more
Navigate the Medicare Part A and B Appeals Process with Ease
Dig into the 5 levels of the appeals process. You submit a claim to your Medicare Adminis... Read more
Reader Question:
Are Fatigue and Asthenia the Same? Find Out
Question: In a patient with confirmed cancer, our oncologist documented fatigue. How can w... Read more
Are Fatigue and Asthenia the Same? Find Out
Question: In a patient with confirmed cancer, our oncologist documented fatigue. How can w... Read more
Reader Question:
Rely on Biopsy for Malignant Bladder Tumor Confirmation
Question: Our oncologist treated a patient for suspected bladder cancer. The diagnosis doc... Read more
Rely on Biopsy for Malignant Bladder Tumor Confirmation
Question: Our oncologist treated a patient for suspected bladder cancer. The diagnosis doc... Read more
Reader Question:
Differentiate Collection and Transfusion of Autologous Blood
Question: How can we bill for outpatient autologous blood transfusions? Are there differen... Read more
Differentiate Collection and Transfusion of Autologous Blood
Question: How can we bill for outpatient autologous blood transfusions? Are there differen... Read more
Reader Question:
Service Duration, Payer Policies Influence Observation Coding
Question: A patient with hematological malignancy was given chemotherapy subsequent to whi... Read more
Service Duration, Payer Policies Influence Observation Coding
Question: A patient with hematological malignancy was given chemotherapy subsequent to whi... Read more
You Be the Coder:
Check Laterality for Hearing Loss
Question: Our physician documented a diagnosis of mixed hearing loss in a patient who was ... Read more
Check Laterality for Hearing Loss
Question: Our physician documented a diagnosis of mixed hearing loss in a patient who was ... Read more
Genetic Counseling:
5 Q&As; Clear Up Your Most Common Genetic Counseling Coding Issues
Find out whether a physician counts as a genetic counselor. Suppose a pancreatic cancer p... Read more
5 Q&As; Clear Up Your Most Common Genetic Counseling Coding Issues
Find out whether a physician counts as a genetic counselor. Suppose a pancreatic cancer p... Read more
Coding Quiz:
Find Out When You Should—And Shouldn't—Apply a Cancer History Dx
Watch out: Some of these answers don't require an ICD-10 code at all. When a patient deta... Read more
Find Out When You Should—And Shouldn't—Apply a Cancer History Dx
Watch out: Some of these answers don't require an ICD-10 code at all. When a patient deta... Read more
Observation Care:
CMS Finds Observation Care Claims Often Lack Appropriate Documentation
Incorrect coding errors also plague these services. It's a common occurrence at your onco... Read more
CMS Finds Observation Care Claims Often Lack Appropriate Documentation
Incorrect coding errors also plague these services. It's a common occurrence at your onco... Read more
Hemophilia:
Do You Know These Hemophilia Types? Find Out
Here's what von Willebrand's factor means. In last month's Oncology Coding Alert, you lea... Read more
Do You Know These Hemophilia Types? Find Out
Here's what von Willebrand's factor means. In last month's Oncology Coding Alert, you lea... Read more
Reader Question:
Differentiate Between Inpatient, Office Consult
Question: Is there a difference between an office consultation and an inpatient consultati... Read more
Differentiate Between Inpatient, Office Consult
Question: Is there a difference between an office consultation and an inpatient consultati... Read more
Reader Question:
Get Ready for LCD Updates
Question: One of my colleagues said that Medicare is changing LCDs to eliminate ICD-10-CM ... Read more
Get Ready for LCD Updates
Question: One of my colleagues said that Medicare is changing LCDs to eliminate ICD-10-CM ... Read more
Reader Question:
Confirm Pathology before Selecting Mohs Codes
Question: A patient presented to our physician with a diagnosis of primary squamous cell c... Read more
Confirm Pathology before Selecting Mohs Codes
Question: A patient presented to our physician with a diagnosis of primary squamous cell c... Read more
You Be the Coder:
Biopsy Isn't Mandatory to Diagnose Cancer
Question: In an elderly patient, who showed signs of bone metastasis, our physician wants ... Read more
Biopsy Isn't Mandatory to Diagnose Cancer
Question: In an elderly patient, who showed signs of bone metastasis, our physician wants ... Read more
Hematology:
Here's How to Collect the Clotting Factor Pay You Deserve
You'll need to make a distinction between acquired and congenital hemophilia A. Do you fi... Read more
Here's How to Collect the Clotting Factor Pay You Deserve
You'll need to make a distinction between acquired and congenital hemophilia A. Do you fi... Read more
CMS:
CERT Report Says 3.0 Percent of Oncology / Hematology Visits Were Paid Improperly
Hint: Zero in on your oncology radiation therapy claims. Your oncology practice is probab... Read more
CERT Report Says 3.0 Percent of Oncology / Hematology Visits Were Paid Improperly
Hint: Zero in on your oncology radiation therapy claims. Your oncology practice is probab... Read more
Incident-To:
Follow This Expert Advice for Smart 'Incident to' Billing
Identify NPP services, describe direct supervision, and check payer guidelines. ‘Incide... Read more
Follow This Expert Advice for Smart 'Incident to' Billing
Identify NPP services, describe direct supervision, and check payer guidelines. ‘Incide... Read more
Reader Question:
Cystoscopic Surveillance Does Not Guide Your Bladder Cancer Reporting
Question: Please provide directions for reporting ‘history of bladder cancer' versus ‘... Read more
Cystoscopic Surveillance Does Not Guide Your Bladder Cancer Reporting
Question: Please provide directions for reporting ‘history of bladder cancer' versus ‘... Read more
Reader Question:
Choose Your Scope Code Based on Examined Area
Question: If the oncologist inserts a scope through the nose to examine the larynx, is thi... Read more
Choose Your Scope Code Based on Examined Area
Question: If the oncologist inserts a scope through the nose to examine the larynx, is thi... Read more
You Be the Coder:
Malignant Bladder Tumor
Question: Our oncologist treated a patient for suspected bladder cancer. The diagnosis doc... Read more
Malignant Bladder Tumor
Question: Our oncologist treated a patient for suspected bladder cancer. The diagnosis doc... Read more
CCI 25.0:
Confused by Recent Biopsy Denials? Latest Round of CCI Edits May Be to Blame
These modifier indicator updates may be the subtlest changes to learn. As is typical of t... Read more
Confused by Recent Biopsy Denials? Latest Round of CCI Edits May Be to Blame
These modifier indicator updates may be the subtlest changes to learn. As is typical of t... Read more
ICD-10-CM:
Prevail Over Cutaneous T Cell Lymphoma Denials with This Advice
Check site of lymph nodes; distinguish mycosis fungoides vs. Sézary disease. Cutaneous T... Read more
Prevail Over Cutaneous T Cell Lymphoma Denials with This Advice
Check site of lymph nodes; distinguish mycosis fungoides vs. Sézary disease. Cutaneous T... Read more
Modifiers:
Heads up: Spotlight's on Modifier 57. Can You Withstand RAC Scrutiny?
You probably use this modifier now and then – find out what's under review. If your onc... Read more
Heads up: Spotlight's on Modifier 57. Can You Withstand RAC Scrutiny?
You probably use this modifier now and then – find out what's under review. If your onc... Read more
Reader Question:
Butting Heads with Your Physician? Try This
Question: I have a doctor that wants to see in writing where she has to document anywhere ... Read more
Butting Heads with Your Physician? Try This
Question: I have a doctor that wants to see in writing where she has to document anywhere ... Read more
Reader Question:
Break Down These Inpatient Initial Care Codes
Question: Can you use inpatient initial care codes 99221-99223 more than once in the same ... Read more
Break Down These Inpatient Initial Care Codes
Question: Can you use inpatient initial care codes 99221-99223 more than once in the same ... Read more
You Be the Coder:
Differentiate Testicular and Scrotal Pain
Question: Our physician has documented pain in testicles and has not arrived at a definite... Read more
Differentiate Testicular and Scrotal Pain
Question: Our physician has documented pain in testicles and has not arrived at a definite... Read more
Coding Quiz:
Brush Up on Your Chemo Admin Coding Skills with This Detailed Example
Hint: Remember to apply modifier JW. New year, new problems? Hardly. Coding chemotherapy ... Read more
Brush Up on Your Chemo Admin Coding Skills with This Detailed Example
Hint: Remember to apply modifier JW. New year, new problems? Hardly. Coding chemotherapy ... Read more
News You Can Use:
CMS Pauses Plan to Blend E/M Payments
Medicare offers a new payment proposal for 2021. In the annual CMS Medicare Physician Fee... Read more
CMS Pauses Plan to Blend E/M Payments
Medicare offers a new payment proposal for 2021. In the annual CMS Medicare Physician Fee... Read more
2019 Fee Schedule:
Telehealth, Virtual Care Getting More Recognition
Use these Medicare G codes for certain services. Coders who want to remain up-to-date on ... Read more
Telehealth, Virtual Care Getting More Recognition
Use these Medicare G codes for certain services. Coders who want to remain up-to-date on ... Read more
Reader Question:
Can You Code Counseling with Vaccination on Same Day? Find Out
Question: Our physician administered the human papillomavirus (HPV) vaccine and did counse... Read more
Can You Code Counseling with Vaccination on Same Day? Find Out
Question: Our physician administered the human papillomavirus (HPV) vaccine and did counse... Read more
Reader Question:
Check That You Have Trained Counselor for 96040
Question: Can we submit code 96040 for genetic counseling? Is it correct to submit E/M cod... Read more
Check That You Have Trained Counselor for 96040
Question: Can we submit code 96040 for genetic counseling? Is it correct to submit E/M cod... Read more
You Be the Coder:
Here's the Difference Between Excision vs Destruction
Question: Is there a difference between excision and destruction of basal cell carcinoma? ... Read more
Here's the Difference Between Excision vs Destruction
Question: Is there a difference between excision and destruction of basal cell carcinoma? ... Read more