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bladder cancer vs history of cancer for BCG treatment


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I need some help. Our office does many treatments for bladder cancer with BCG and I am having a hard time getting the Dr.'s to understand that if the patient is still being treated with BCG then we need to code it with Cancer not history of after they remove it. The documentation of the visit also does not have enough to change from history of to cancer. Does anyone have any suggestions? I keep getting the response that they are following AUA guidelines.

Machelle Freeman

Eagan, MN
Best answers
I agree with you. Insurance doesn't like paying with a history code. If they are treating it then it needs to stay active. We have the same problem on our end. We seem to have patients that switch back and forth because of the BCG treatments. If they are more than a year apart, we switch it to history and switch it back to active once they come back for BCG later. It gets frustrating. We switch it to active cancer when they are treating it.

Machelle Freeman, CPC