Oncology & Hematology Coding Alert

Question: The March issue of Oncology Coding Alert included a list of National Correct Coding Initiative edits for IMRT. Do these edits just mean we shouldn't report the codes together on the same day or that we can't report the codes at any time during IMRT treatment? We are a hospital-based radiation oncology practice. Florida Subscriber
Answer: Good question -- CMS- original intent for NCCI was to bundle services performed on the same service date by the same provider. But some Medicare contractors have issued more stringent bundling guidelines that include bundling for a course of treatment rather than a single service date. Best bet: Review your local policies to ensure compliance with the Medicare contractor. And remember, commercial insurers don't always follow the same bundling rules, so check with individual payers on their rules to be sure you comply with managed care and other contracts. Protect yourself: You should follow payer guidelines, then AMA guidelines, and then standard-of-practice information from specialty societies, in that order.