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Oncology & Hematology Coding Alert

News You Can Use:
Finalize Your Understanding of the 2024 PF5
CMS makes good on its earlier proposals. In Oncology & Hematology Coding Alert volume... Read more
Coding Quiz:
Wrap Up 2023 With This End-of-Year Coding Quiz
Find out if you're ahead of the coding curve. As always, there were a lot of changes in t... Read more
Practice Management:
Know These 3 Things to Bill ACP Services With Confidence
Get reimbursed for services you may be offering for free. According to a poster session a... Read more
Coding Quiz Answers:
Check Your Answers to Our End-of-Year Coding Quiz
Don't let your coding skills get left in the past. Once you've answered the quiz question... Read more
Reader Question:
Bill for Follow-Up Rad Onc E/Ms When Appropriate
Question: I have two questions regarding follow-up appointments for the prostate pati... Read more
Reader Question:
Include This Term to Code PNET With Accuracy
Question: Based on the pathology results, my provider has diagnosed a patient as havi... Read more
Reader Question:
Code Different MZLs With Caution
Question: How would you code marginal zone lymphoma (MZL) with spleen involvement? My... Read more
You Be the Coder:
Choose This Code for Ductal Carcinoma Excision
Question: What is the correct CPT® code for this surgery? Indications: Invasive duc... Read more
Procedure Coding:
Pick Prostate Cancer Biopsy Codes Precisely
Know when to go beyond 55700. Confused as to which code to use when your provider perform... Read more
E/M Coding:
Know What Matters in the Latest CMS E/M Services Guide
Medicare prolonged services and documentation guidelines get further clarification. On Au... Read more
Modifiers:
Remember These 3 Rules for Modifier 25 Use
Separate, significant, and same day spell successful application. When you attach modifi... Read more
You Be The Coder:
Get Into Depth With This Lesion Removal Encounter
Question: One of our plastic surgeons removed 10 benign masses measuring between 3 an... Read more
Reader Question:
Consult This Medicare NCD for Correct PET Scan Modifier Use
Question: I received a Medicare claim rejection for 78816-PI, citing inconsistent mod... Read more
Reader Question:
Don’t Finalize This Phyllodes Tumor Dx Yet
Question: I have a patient with recurrent malignant phyllodes tumor of the right brea... Read more
Reader Question:
Understand Who Has Ultimate Authority Over Dx Assignment
Question: Who is responsible for the final diagnosis used for an office/ outpatient e... Read more
News You Can Use:
Know What’s Coming Your Way in the 2024 CPT® Updates
Major chemo changes, minor E/M time shifts lead the way. The annual updates to the CPT®... Read more
Coding Quiz:
Raise Your Breast Cancer Coding Awareness With This Quiz
Know how to navigate within and beyond the C50.- codes. October is breast cancer awarene... Read more
Practice Management:
Get the Answers to Your Frequently Asked New/Established Patient Questions
The three-year rule isn't the only thing you need to know. Evaluation and management (E/... Read more
Coding Quiz Answers:
Check Your Answers to Our Breast Cancer Coding Quiz
See if it's time to brush up your ICD-10-CM guideline knowledge. Once you've answered the... Read more
Reader Questions:
Document Provider Involvement for Treatment Device Complexity
Question: What documentation is needed for codes 77332-77334? I was given some notes... Read more
Reader Questions:
Take This Tip for Successful ECG Reporting
Question: Techs employed by our center perform electrocardiograms (ECGs) on certain p... Read more
Reader Questions:
Select This Code for Sex-Cord Stromal Tumors
Question: We received a report from the path lab that said “right ovarian cyst res... Read more
You Be the Coder:
Pinpoint These Codes for Med Refill Encounters
Question: If a patient comes in for medication refills for a chronic condition, and t... Read more
News You Can Use:
Know the Ups and Downs of the 2024 Proposed Rule
A 3 percent CF reduction is just the tip of the iceberg. The Centers for Medicare & ... Read more
Condition Spotlight:
Use This Guide to Perfect Your Blastoma Coding
And brush up on your medical terminology at the same time. You probably already know that... Read more
Practice Management:
Hear This Advice to Make Your Practice Deaf Accessible
It's not just a good idea. It's also the law. Is your practice taking steps to accommodat... Read more
Reader Questions:
Stay on the Level With This E/M Advice
Question: I code for an outpatient bone marrow transplant clinic, and my providers be... Read more
Reader Questions:
Take This Advice for Drug Waste Billing
Question: I keep hearing there is a 10 percent threshold on the percentage of drug wa... Read more
Reader Questions:
Count on This Time-Based Coding Guidance
Question: If a provider documents total time spent on the encounter, and includes a s... Read more
You Be the Coder:
Get the Right Results By Avoiding These Biopsy Blunders
Question: What code(s) should I use for an ultrasound-guided core needle biopsy of an... Read more
News You Can Use:
Know These 5 Critical ICD-10-CM 2024 Updates
Don't let these changes become an October surprise. The 2024 update to ICD-10-CM isn't la... Read more
Procedure Coding:
Follow These Steps for Precision Rad Onc Coding
And pay attention to these valuable documentation tips. Even though radiation oncology ha... Read more
Guidelines:
Get the Answers to Your Frequently Asked Excludes Questions
Know what should — and what should not — be included. If you are confused about the... Read more
Reader Questions:
Check This CT Component Advice for IMRT
Question: I am in the middle of a debate where I work. My intensity modulated radiation th... Read more
Reader Questions:
Take This Advice, Code BME Confidently and Correctly
Question: I've seen bone marrow edema (BME) documented quite a bit recently, but I've rece... Read more
Reader Questions:
Document Thinking to Count Tests Not Ordered
Question: I know that CPT® guidelines state we cannot count a test toward an evaluation a... Read more
You Be the Coder:
Peruse Payer Preference for Post-PHE Telehealth Visits
Question: I am still very confused about the correct modifiers to use for telehealth visit... Read more
Infusion Coding:
Adopt These 4 Tips to Avoid Infusion Confusion
Keep these rules and definitions close at hand. Little in oncology coding is more complex... Read more
ICD-10-CM Guidelines:
Perfect Your Oncology Dx Coding With These Guideline Takeaways
Hint: Remember to code first the reason for the encounter. The chapter-specific guidelin... Read more
Compliance:
Let Medical Necessity Be Your Practice Monitor
Does your practice measure up to these OIG recommendations? You see the term “medical ... Read more
Reader Questions:
Unlearn This Unlisted Code Idea
Question: Can I append a modifier to an unlisted CPT® code? I'm having trouble getti... Read more
Reader Questions:
Don’t Fail to Follow This First-Listed Code Rule
Question: We have been getting denials recently from Blue Cross Advantage Plus in Mic... Read more
Reader Questions:
Hold Back on Implementing Cigna’s -25 Policy … Again
Question: Is Cigna now requiring the submission of documentation via email or fax to ... Read more
You Be the Coder:
Make Your Way Through This E/M Drug Admin Modifier Mess
Question: I am a facility coder, but I see both profee and facility codes on the bill... Read more
Procedure Coding:
Learn The Dos and Don’ts of IMRT Delivery Coding
Let this guide lead you to the correct guidance codes. To code intensity modulated radiat... Read more
Coding Quiz:
Answer These Questions, Master Repeat/Related Procedure Modifier Use
And refresh your memory of these modifier functions. Sometimes in the process of treating... Read more
ICD-10-CM Coding:
Understand Long-Term Current Drug Therapy Codes With This FAQ
Here's the what, when, why, and how behind the Z79.6- codes. You may remember that, on O... Read more
Coding Quiz Answers:
Check Your Answers to Our Repeat/Related Modifier Coding Quiz
Time to find out if you really are a modifier maven. Once you've answered the quiz ques... Read more
Reader Questions:
Read Index Closely for Correct Lumpectomy Code Selection
Question: I'm trying to determine the appropriate ICD-10-CM code for a patient who h... Read more
Reader Questions:
Be Consistent With Coding Suspected Diagnoses
Question: A patient presented to the office with a painless lump behind their ear. O... Read more
Reader Questions:
Use This Modifier to End Multiple Modifier Muddles
Question: When billing for erythropoiesis-stimulating agents (ESA) drugs such as darb... Read more
You Be the Coder:
Help Yourself to This Hematuria Advice
Question: In our oncology practice, I am sometimes called on to code for hematuria, b... Read more
News You Can Use:
Take Note of These 4 Coding, CMS Updates
SDoH guidelines, HCC realignments, and a new BPH ablation procedure share the spotlight. ... Read more
Telehealth:
Dial in These Post-PHE Telehealth Changes
Make sure you have all these deadlines in your 2023 calendar. On Jan. 30, 2023, the Biden... Read more
Condition Spotlight:
Know These 3 Things for Crisis-Free SCD Coding
Don't complicate your understanding of this genetic blood disorder. Coding for sickle-c... Read more
Reader Questions:
Remove This Misunderstanding for Basal Cell Carcinoma Treatment
Question: Is there a difference between excision and destruction of basal cell carcinoma? ... Read more
Reader Questions:
Specify Site, End Spinal Tumor Confusion
Question: How do I report malignant meningeal and spinal cord tumors? Florida Subscriber ... Read more
Reader Questions:
Reevaluate E/M Use in Screening Colonoscopy Consults
Question: A patient came into our office because they have a family history of colon cance... Read more
You Be the Coder:
Split This Chemo Claim With a Medicare Modifier
Question: We performed the following services: Dexamethsone: 10:03-10:20 Benadryl®: 10... Read more
CPT® Coding:
Plan for Radiation Treatment Coding Success
But pay attention to two critical NCCI edits. Good beginnings to radiation therapy progra... Read more
Mythbusters:
Bust These Myths to Make Personal and Family History Coding Easy
And don't forget: the reason for the encounter always comes first. Codes from Z77-Z99 pr... Read more
Practice Management:
Understand PHI, Boost Your HIPAA Comprehension
And remember these gray areas when you're in doubt. Whether it's time for your annual HIP... Read more
Reader Questions:
Be Specific in Primary CNS Lymphoma Code Choice
Question: What is the correct code for primary central nervous system (CNS) l... Read more
Reader Questions:
Don’t Be an April Fool and Ignore These New Dx Codes
Question: Have new codes been recently added to ICD-10-CM? I thought new codes only c... Read more
Reader Questions:
Mind This Advice for Medicare MUE Denials
Question: Medicare is giving me a medically unlikely edit (MUE) on J9045, saying the ... Read more
You Be the Coder:
Understand Etiology, Code This Cancer Correctly
Question: What is the correct way to code a mediastinal mass? When I look up mass in ... Read more
ICD-10-CM Coding:
Let This Guide Take the Pain out of G89 Coding
Hint: Begin by carefully reading ICD-10-CM guidelines. The G89 (Pain, not elsewhere class... Read more
Modifiers:
Don’t Get Left in the Dark Choosing the Right Laterality Modifier
Look to payer fine print for the final word. You know CPT® is full of codes that descri... Read more
Procedure Coding:
Avoid Transfusion Confusion With These 4 Tips
Here's what those HCPCS Level II blood product codes describe. Transfusions play a key p... Read more
Reader Questions:
Don’t Leap to This Lesion Dx
Question: Our oncologist met with a patient to discuss the best way to manage her bra... Read more
Reader Questions:
Look for These Terms, Locations for Central Breast Dx Codes
Question: Is there guidance around what constitutes as the central portion of the bre... Read more
Reader Questions:
Check This Principal Dx Guideline for Chemo Denial
Question: Blue Cross Blue Shield (BCBS) of Illinois is denying 96402 when billed for ... Read more
You Be the Coder:
Rely on Index to Make Mediastinal Mass Code Choice
Question: What is the correct way to code a mediastinal mass? When I look up mass in ... Read more
ICD-10-CM Coding:
Take 3 Steps to Be Certain With Uncertain/Unspecified Code Choices
Know why the distinction goes beyond the correct dx. Of all the choices oncology coders ... Read more
Coding Quiz:
Let’s Get Critical With This 99291/+99292 Quiz
How much do you really know about critical care services? They may have short descriptor... Read more
Condition Spotlight:
Heed This Advice for Correct Kaposi Sarcoma Coding
Hint: Code to location, not to etiology. Few of us knew about Kaposi sarcoma (KS) until t... Read more
Coding Quiz Answers:
Check Your Answers to Our Critical Care Coding Quiz
Time to find out if you really are an E/M expert. Once you've answered the quiz questions... Read more
Reader Questions:
Don’t Deny This Documentation Advice
Question: I am working a denial with 77427 per the Humana policy. I know that Humana ... Read more
Reader Questions:
Encounter This Code First Instruction for Colorectal Screens
Question: A patient had a colonoscopy due to a personal history of colon polyps. They... Read more
Reader Questions:
Receive This Advice for ER+/ER- Coding
Question: If a patient has current breast cancer, instructions for the C50.- codes te... Read more
You Be the Coder:
Point to Purpose for Precise Port-a-Cath Coding
Question: What first-listed diagnosis code should I use to go with CPT® 36561 for ch... Read more
Final Rule:
Learn How the CY 2023 Final Rule Will Impact Oncology
This year's MPFS mixes the good and the bad with the delayed. The 2023 Medicare Physician... Read more
Prolonged Services:
Add to Your Prolonged Service Coding Understanding With This Guide
CMS and CPT® still at odds over when to add extra time. CMS's 2023 Physician Fee Schedu... Read more
Clip & Save:
Consult This Chart to Select Codes, Locate Thresholds
To avoid confusion over code choice for your Medicare and private payer patients, and to c... Read more
Mythbusters:
Bust These 4 Myths for Lung Cancer Dx Coding Success
Check to see if you're correctly coding these common situations. Coding lung cancer, like... Read more
Reader Question:
Look to Condition, not Time, for Correct Z79 Code Use
Question: I have always used three months or longer as the cut off to apply the Z79 c... Read more
Reader Question:
Don’t Separate These Physics Codes by PC/TC
Question: I need to bill only the professional component for 77336 and 77370 with pla... Read more
Reader Question:
Use This Code for Testicular Pain
Question: If a provider documents that a patient has testicular pain, do I use N50.82? Ha... Read more
You Be the Coder:
Code These Chemo Drug Combinations Cautiously
Question: AAPC's 2023 ICD-10-CM Expert “Appendix A: Z Codes for Long-term Use of Dr... Read more
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