Oncology & Hematology Coding Alert

For accurate claims, distinguish these professionals from 'clinical staff.'The definition of "other qualified health care professional" didn't make it into the CPT® 2012 manual, but you need to know and apply this definition all the same. The AMA lists the definition as part of the "CPT® 2012 Errata" on its website (www.ama-assn.org/resources/doc/cpt/cpt-corrections.pdf). The definition is as follows:"A 'physician or other qualified health care professional' is an individual who is qualified by education, training, licensure/regulation (when applicable), and facility privileging (when applicable) who performs a professional service within his/her scope of practice and independently reports that professional service. These professionals are distinct from 'clinical staff.' A clinical staff member is a person who works under the supervision of a physician or other qualified health care professional and who is allowed by law, regulation and facility policy to perform or assist in the performance of a specified professional service, but who [...]