Oncology & Hematology Coding Alert

Question: I've been linking the cancer's ICD-9 code to the oncologist's phlebotomy services and getting denials. What ICD-9 code should I use?

Connecticut Subscriber Answer: When oncology practices have trouble getting paid for the oncologist's phlebotomy services, the reason is usually improper ICD-9 codes. Many oncology coders mistakenly treat therapeutic phlebotomy coding the same as chemotherapy treatment coding by linking cancer diagnosis codes to a phlebotomy procedure code, such as 99195 (Phlebotomy, therapeutic [separate procedure]). 
 
Instead, you should use one of these ICD-9 codes:

   238.4 - Polycythemia vera
   238.7 - Other lymphatic and hematopoietic tissues
   275.0 - Disorders of iron metabolism
   277.1 - Disorders of porphyrin metabolism
   285.0 - Sideroblastic anemia
   289.0 - Polycythemia, secondary.
 
In addition, make sure you're supplying a sufficient amount of medical documentation. The patient's record should include details of the condition the oncologist treated and the date of the service. The documentation should also indicate either the patient's red blood cell mass or a pre-phlebotomy hematocrit of more than 60 percent.