chemotherapy

  1. K

    Wiki Drug therapy requiring monitoring for ongoing treatments

    So I have mixed thoughts on the MDM area for what can qualify as drug therapy requiring monitoring. I know the guidelines of what drugs qualify, however what about patients that are on radiation therapy or chemotherapy and we are continuing the same treatment with no changes. Does this still...
    • kathleeng
    • Thread
    • chemotherapy drug therapy infusion new mdm ongoing chemo ongoing radiation ongoing treatments requiring monitoring treatment
    • Replies: 1
    • Forum: E/M
  2. T

    Wiki Herceptin

    Is anyone getting requests for documentation for Herceptin, we send what they are requesting and Medicare denies it. It meets guidelines i'm just not sure what were doing wrong. Has anyone experienced this?
  3. A

    Wiki -59 Modifier on HCPCS codes

    We are having an issue where Regence is denying the second line of J9055 because "modifier -59 is not valid with HCPCS code J9055." We are billing separate lines to bill 2 different NDC#s. How are we to code the two lines without modifier -59? Do we bill without a modifier or just lump the 2...
    • Aflory5
    • Thread
    • chemotherapy hcpcs hcpcs modifiers infusion coding modifier 59
    • Replies: 0
    • Forum: Modifiers
  4. J

    Wiki Z51.11 and Z51.12

    If a patient is receiving a few different infusions, some anti-neoplastic and some Immunotherapy, at the same time. Do you use both Z51.11 and Z51.12? I usually just use the Z51.11 and haven't had a problem but I am questioning what the correct thing is to do? Thanks
  5. C

    Wiki Chemo & Home Health Care

    I code for a home health care agency & the case managers & I are stumped on how to code for our care for chemotherapy patients. We understand that Z51.11 is not for home health care, but is to be used by those actually administering chemotherapy. But, we do a lot of follow-up care - taking...
  6. L

    Wiki Administration coding

    Hello, I am wondering if I can get a few opinions on how these two cases would be billed. I'm not including dosages and pre-meds. I'm really only concerned about two drugs and what administrations are billable. I was instructed to bill 96413, 96415, 96368, 96411 for both cases. First case...
  7. J

    Wiki Chemo Talk with RN - Education

    Up to now, we have done a one hour education "Chemo talk' with patients free of charge. My boss would like me to start billing for this service. My question is, What kind of documentation is needed to bill as a nurse visit - 99211? Is the same documentation needed to bill as an education service...
  8. M

    Wiki Chemotherapy Physician Charge Clarification

    Hello All. I was hoping someone could help clarify a scenario at my job. I work for an outpatient Cancer Center that is part of a hospital. One of the physician's questioned how the company that handles his professional billing can successfully bill and be reimbursed for observation of the...
  9. S

    Wiki Coding Neuropathy due to chemotherapy

    Could anyone help me find this ICD 10 code for Neuropathy due to chemotherapy treatment? Thanks
  10. M

    Wiki Chemo injxn-intra-arterial-head

    01/15/16 Folks, What codes would you use for this one? PROCEDURE: The skin of the groin was prepped and draped in sterile fashion and local anesthesia using 1 percent buffered lidocaine was infused over the right common femoral artery. Using Seldinger technique a 21g needle was inserted into...
  11. J

    Wiki Premedications before chemotherapy infusion

    Does anyone know if it would be applicable to bill for premedications (benadryl, zofran, etc) given prior to the start of chemotherapy? This would be for facility coding. Please send any references you have and cpt's to bill. Thanks!!
  12. bproosow

    Wiki Active or History? Follow-up oncology visit with no further treatment

    We are having a heated debate here on this subject. Here is the scenario: Patient has cancer, let's just say colon cancer. Goes in for hemicolectomy. Surgery goes well, margins are clear, NED. Up to this point we are coding for the colon cancer. Patient goes for his first follow-up visit with...
  13. bproosow

    Wiki Coding for post-op oncology visit with no further treatment

    We are having a heated debate here on this subject. Here is the scenario: Patient has cancer, let's just say colon cancer. Goes in for hemicolectomy. Surgery goes well, margins are clear, NED. Up to this point we are coding for the colon cancer. Patient goes for his first follow-up visit...
  14. C

    Wiki Post chemo monitoring

    Would V58.69 be an appropriate code for a home health agency to use as primary dx for monitoring a patient currently on chemotherapy, but not administering it? Is there another code that would be better?
  15. M

    Wiki Chemotherapy Infusions

    New to all of this... I have a patient getting IV benedryl , phenergan and decadron prior to chemotherapy. Each only takes 5 minutes to infuse and it is done throught the same IV site as the chemo. Then patient is infused with one chemo drug for 10 minutes and another chemo drug for 3 hours...
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