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Oncology & Hematology Coding Alert

Reader Questions:

Verify VBM Codes

Published on Sun Jul 10, 2005

Question: Last month you featured common codes for Hodgkin treatments. Would you add a chart for VBM?

Wisconsin Subscriber Answer: Here are the codes you need to know for the four-week treatment cycle known as VBM.

For each of these outpatient drugs, Medicare coverage depends on administration being furnished "incident-to" a physician's service if the drugs aren't usually self-administered (Medicare Benefit Policy, Chapter 15, Section 50, "Drugs and Biologicals"). Remember: Incident-to only applies in the office or freestanding center - not in the hospital.
 
To meet all the general requirements of incident-to, according to Medicare Benefit Policy, Chapter 15, Section 50.3, an FDA-approved drug must be administered by the physician (who must furnish the drug) or by his employees while under his supervision and be of a form not usually self-administered.

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