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Oncology & Hematology Coding Alert

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Don't Choke on Oral Antiemetic Coding

Published on Sun Sep 18, 2005

Take advantage of this chart next time you need to match a code to a drug name Keeping track of the multitude of drugs oncologists administer in addition to chemo can be a real hassle, but our handy table will cut your coding time for drugs that prevent nausea and vomiting.

Good news: When antineoplastic chemotherapy treatment is likely to cause vomiting, Medicare covers self-administered antiemetics. Reason: The antiemetic is necessary for administration of the drug. If the antiemetic only enhances tolerance of the chemo, you probably won't receive reimbursement. Helpful: Medicare may also cover an oral antiemetic if IV administration fails.

Watch out: For Medicare to cover the antiemetic, you may need to be sure the provider ordered the drug at the time of chemotherapy administration and gave the antiemetic within a specific time limit following chemo. Play it safe-check your payer guidelines.
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