Oncology & Hematology Coding Alert

You need to know both 'what' and 'where' for success.Denials are occurring left and right due to improper 5010 reporting of "not otherwise classified" codes. Here's how to prevent your claims from getting one of those denials.The Problem: NOC Drug Codes Are Unsupported Giving inadequate information for non-specific HCPCS codes has become one of the most common reasons for rejection of electronic Medicare claims in the 5010 format, stated Cahaba Government Benefit Administrators in an email to providers.Affected codes include those categorized as miscellaneous or "not otherwise classified" (NOC). You can see the current list at www.cms.gov/ElectronicBillingEDITrans/40_FFSEditing.asp, where you'll see familiar codes including J3490 (Unclassified drugs) and J9999 (Not otherwise classified, antineoplastic drugs).The Solution: Fill SV101-7, Not the NTE SegmentAny time your practice submits an electronic 5010 claim for a code on the list, not only must you provide a more detailed description, you must provide it in the [...]