Oncology & Hematology Coding Alert

Question: We have a patient with chronic myeloid leukemia who undergoes regular chemotherapy injection treatments of Gleevec. He reported to the office recently feeling sluggish. The oncologist, who had already diagnosed the patient as anemic, examined the patient and gave him a 500-unit shot of epoetin alpha. Can we report the injection and office visit separately?

Mississippi Subscriber Answer: If the oncologist previously diagnosed the anemia, you cannot report a separate E/M service. When the oncologist treats anemia in a leukemia patient, you should:

report 90782 (Therapeutic, prophylactic or diagnostic injection [specify    material injected]; subcutaneous or intramuscular) for the injection.

attach ICD-9 code 285.22 (Anemia in neoplastic disease) to 90782.

report Q0136 (Injection, epoetin alpha [for non-ESRD use], per 1,000 units) for the drug supply. - Clinical and coding expertise for this issue of Oncology Coding Alert provided by Cindy Parman, CPC, CPC-H, RCC, co-owner of Coding Strategies Inc. in Dallas, Ga.

Correction appeared in February 2005 issue as:
The drug Gleevec is a tablet and cannot be given via injection.