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Oncology Coding

  1. #1
    Location
    Greensboro, NC
    Posts
    67
    Default Oncology Coding
    Medical Coding Books
    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

  2. #2
    Location
    Sioux Falls, SD
    Posts
    11
    Default
    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.

  3. #3
    Default
    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 !!

  4. #4
    Default
    Quote Originally Posted by cpccoder2008 View Post
    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 !!
    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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