I code for an Oncology/Hematology clinic with 6 MD's. No E/M, just dx and procedure coding. All of our patients are obviously complex, however many things need to be considered when deciding just how complex. For instance a 45 yr old otherwise healthy female with 174.9, V86.0 currently in her 3rd year of Tamoxifen V07.51 is fairly straight forward with bi-annual CBC's and Ca 125. Then a 82 year old female with 174.9, v86.0, 285.22, 285.21, 585.3, 288.03, 287.49, e933.1, 428.0, 250.00, v58.67, 783.21, 268.9, and 427.31, V58.61.......see what I mean? I won't even get started on the Chemo drugs she is on, her adverse effects to them, the meds she takes to counter act those effects, in addition to her regular meds for her co-morbidities.
Neoplasm by itself is a complex disease with some serious MDM skills required, but sometimes it can be straight forward, and sometimes very chaotic, not to mention the fine line that often runs down the middle!
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