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Trouble getting paid

  1. #11
    Location
    Columbia, MO
    Posts
    12,571
    Default
    Exam Training Packages
    the chemo admin codes are the range of 96401 thru 96549. They are in the CPT book right after your regular infusion codes.

    Debra A. Mitchell, MSPH, CPC-H

  2. Default
    Physicians office. So I guess they are doing wrong, b/c we in most cases, are getting paid for only the office visit.
    Finance Analyst

  3. Default Thank you
    Thank you -you have helped me sooo much. THank you!!!!!
    Finance Analyst

  4. #14
    Location
    Columbia, MO
    Posts
    12,571
    Default
    the payers usually default to the least paying line item which in this case is usually the ov. So yes you must drop the ov. When you have scheduled a patient to return for chemo admin then you cannot make a case for a separately identifiable office encounter. Even tho the provider does see the patient briefly prior to the administration the determination to give the chemo has already been made, on the occaision where the patient present too ill for the chemo then you may charge the ov but there will be no admin code.

    Debra A. Mitchell, MSPH, CPC-H

  5. Default One last thing
    Do you have an email i could email you at with any future questions?

    Also, one quick question....if billing a J1642 is this the code you say needs to be billed with the chemo. infusion codes????
    Finance Analyst

  6. Default Initial pump encounter
    If the pt is here to get 24 hour pump how do you bill???
    Finance Analyst

  7. #17
    Location
    Columbia, MO
    Posts
    12,571
    Default
    J1642 is for the heparin, 5FU is a chemo drug.
    if the purpose for the encounter is to insert the pump and start the chemo then use the pump inititation code with the drug, no office visit. I am fairly certain the pump code is inclusive with the intiation charge.

    Debra A. Mitchell, MSPH, CPC-H

  8. #18
    Location
    Columbia, MO
    Posts
    12,571
    Default
    oh sorry my email is debraawm@yahoo.com.

    Debra A. Mitchell, MSPH, CPC-H

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