Oncology & Hematology Coding Alert

Use this quick tip to keep from reinventing the wheel

Medical technologies often evolve faster than the CPT manual, and drug and equipment manufacturers have a vested interest in making sure that carriers pay physicians for using the latest innovations, even if CPT codes don't exist to describe them.

If your oncology department uses equipment and techniques for which CPT does not include a code, you may be able to enlist the manufacturer's help collecting appropriate reimbursement.

Manufacturers often maintain free information and help lines to advise physician practices on how to approach insurers regarding new technologies, says Laureen Jandroep, OTR, CPC, CCS-P, CPC-H, CCS, director and senior instructor for CRN Institute, an online coding certification training center based in Absecon, N.J. And they are sometimes instrumental in gaining approval for new CPT codes to describe previously unlisted procedures.

But use caution when applying manufacturers' suggestions. You are responsible for the accuracy of your coding, and you should never misrepresent a claim to gain payment. Be sure you stick to unlisted-procedure codes when no other code describes the procedure you performed, and always provide ample documentation to justify the claim's necessity.