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Oncology Coding

C

cynthiar

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67
Location
Greensboro, NC
For oncology practices, are you using PQRI's on your chemotherapy patients? Are there many quality codes to chose from?

Also do you charge for a plan of treatment, and if so, what codes do you use?
Thanks for any help, I am not real familiar with oncology practices.
Cynthia
 
My Dr chose to report on 4 measures: 69 - multiple myeloma, 70 - CLL, 71 - breast ca, and 72 - colon ca. I am not aware of any CPT for treatment plan. He codes the appropriate E/M based on time.
 
New to this so i might be wrong but according to my research you can only bill the initial e/m before chemo all other visit's are bundled unless a complication arising the you would attach -25. That being said i would bill the initial/subsequent office visit up until the point the doctor decides to perform chemo. My doctor might see a patient 4-5 times before he decides to perform chemo so i would bill those days and if he does perform chem i would only bill the chemo. Not sure if that is the plan of treatment you are talking about. If not then sorry i but in !! :D
 
cpccoder2008 said:
New to this so i might be wrong but according to my research you can only bill the initial e/m before chemo all other visit's are bundled unless a complication arising the you would attach -25. That being said i would bill the initial/subsequent office visit up until the point the doctor decides to perform chemo. My doctor might see a patient 4-5 times before he decides to perform chemo so i would bill those days and if he does perform chem i would only bill the chemo. Not sure if that is the plan of treatment you are talking about. If not then sorry i but in !! :D
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The E/M codes are not bundled with chemotherapy. If the patient sees the doctor and receives chemo the same day, you need to add a 25 mod to the E/M.

As far as PQRI measures, my physicians have decided to use 4: Biphosphinates, EMR, ERx, and Advanced Directives. We have it built in our system to blow in the correct PQRI's dependent on the documentation. Hope this helps!
 
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