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Oncology & Hematology Coding Alert

HCPCS 2019:
New Injection Codes Mean You Need to Get Your Unit Calculations Up to Date — Before Jan 1
Good news: In many cases, you're shifting from a temporary code. The Centers for Medicare... Read more
Compliance:
5 Tips Will Help You Avoid Signature Error Denials
Avoid this common CERT Program pitfall finding You've got a perfectly coded claim—so th... Read more
Flu Coding:
Here's Why You Could Report Multiple Units of 87804
Here's why you need to keep modifiers 59, QW on hand. The plethora of influenza virus str... Read more
Reader Question:
Define These ABN G Modifiers
Question: I'm filing a claim that includes an advance beneficiary notice (ABN) for a Medic... Read more
Reader Question:
Here's How to Report ECGs
Question: Techs employed by our center perform ECGs on certain patients to check for toxic... Read more
Reader Question:
You Should Apply J3430 for Vitamin K Injections
Question: My physician gave a patient a 10 mg injection of vitamin K. How should I report ... Read more
You Be the Coder:
Search for a Single Code for Infusion, Injection, and Hydration
Question: It is possible to bill for non-chemo infusion 96365 and 96367 and hydration ther... Read more
HCPCS:
Bust These 5 Myths to Boost Your J9310, J9035 Coding Accuracy
Don't forget to convert milligrams to units to capture every dollar you deserve. If you'r... Read more
Diagnostic Tests:
Here's Your Primer to Outpatient Diagnostic Test Supervision Requirements
Go here to untangle Medicare's layers of definitions and numerical indicators for yourself... Read more
News You Can Use:
Medicare Carrier Loosening Some NPP E/M Rules
NGS will allow NPPs to code same-day E/Ms under certain circumstances. If you've heard of... Read more
Reader Question:
R65.11 Isn't the Only Code for SIRS Case
Question: The physician saw an inpatient with chronic lymphocytic leukemia who was admitte... Read more
Reader Question:
Improve Your Coding Health with This New Flu Vaccine
Question: It seems like every year the AMA adds yet another CPT® code for a flu vaccine. ... Read more
Reader Question:
Distinguish MUE and PTP CCI Edits
Question: What is the difference between Medically Unlikely Edits and Mutually Exclusive E... Read more
You Be the Coder:
When Panel Codes Aren't Precise, Then Do This
Question: A physician orders blood electrolytes potassium, sodium, calcium, chloride, magn... Read more
CPT® 2019 Update:
Breast MRI and BRCA1, BRCA2 Gene Analysis Codes Top Your New Oncology Changes
Missing even subtle revisions could land your claim in limbo. As is the annual expectatio... Read more
ICD-10-CM:
Find Solutions to Your GIST and Pancreatic Carcinoma Questions Here
See how to figure out what code you should report. Oncology coding isn't always cut and d... Read more
Compliance:
HIPAA: Grasp Real Penalty Risk for Privacy Violations
Having a program is not enough. You might think you're safe from enforcement action if yo... Read more
Reader Question:
Watch Before You Report Second Unit of 77295
Question:  A patient who was in treatment with our oncologist is now diagnosed with b... Read more
Reader Question:
Earn for Consultation Services
Question: Our physician offered consultation services to a patient who was in treatment wi... Read more
Reader Question:
Follow Tips for Record Disposal when Moving
Question: Our surgery practice is moving to a new location, and we're purging old patient ... Read more
You Be the Coder:
Distinguish Marrow Aspiration and Biopsy
Question: How is a bone marrow aspiration different from a bone marrow biopsy? Ohio Subsc... Read more
FNA:
3 Tips Transform Thyroid Nodule Fine Needle Claims Into Successful Submissions
Check for biopsy, append appropriate modifiers, and count units. Tally how many lesions a... Read more
Vulvectomy:
Bust 4 Myths to Avoid a $400 Vulvectomy, Integumentary Code Error
You must know the lesion type, size (plus margin), and type of closure. Worst case scenar... Read more
E/M Coding:
Here's Why Strong Notes Will Back Up Your Critical Care Claims
Face-to-face is key to initial hospital services. Oncologists sometimes treat patients wh... Read more
Reader Question:
6 Questions Abolish PHI Risk
Question: I'm always concerned about protecting our patients' health information, especial... Read more
Reader Question:
Confirm Pathology Service before Submitting Mohs Codes
Question: A patient presented to our physician with a diagnosis of primary squamous cell c... Read more
You Be the Coder:
Here's How to Report Sequential Push Administration
Question: In a patient with lymphocytic leukemia, our physician administered meperidine IV... Read more
ICD-10-CM 2019:
Eye These Numerous Eye Lid, Metabolic Disorder, and Infection Following Procedure Additions
Don't forget ‘x' placeholder when applying seventh character to postprocedural infection... Read more
OIG:
Part B Lab Tests Remain a Fixture on the OIG Hit List
Plus: Medicare pay cuts for lab work may lead to reduced testing. Clinical tests are a ne... Read more
Estrogen Receptor Status:
3 Questions Clarify When You Should Use Z17.0 for Current Breast Cancer
Learn which code to add for patients on tamoxifen therapy. Skipping secondary ICD-10-CM c... Read more
Reader Question:
Here's What 'Impacted' Really Means
Question: Our physician sometimes decides a patient with head and neck cancer needs earwax... Read more
Reader Question:
Examine Modifier Q6 for Fill-In Physician
Question: We hired a locum tenens for two weeks. Do we code the same for the replacement p... Read more
Reader Question:
Follow These Modifier 25 Rules for Coding Success
Question: We are not sure when we can append modifier 25. Could you please explain this? ... Read more
You Be the Coder:
Confirm the Ovarian Cyst Fluid Collection Method
Question: Our physician obtained a sample of the fluid from the ovarian cyst under ultraso... Read more
Biopsies:
4 Questions Solve Your Top Integumentary Biopsy Coding Mysteries
Warning: You may lose up to $75 per procedure for any erroneous reporting. Whenever the o... Read more
Coding Quiz:
Quit Making Merkel Cell Carcinoma Coding Mistakes With This Quiz
Keep a keen eye on the anatomic locations of the lesions. In order to maximize your ethic... Read more
E/M Coding:
Capture Concurrent Care Pay With This Expert Advice
First step: Be sure your provider isn't duplicating another's service. When your physicia... Read more
Coding Quiz Answers:
These 5 Merkel Cell Carcinoma Answers Show How Site, Side Matters
See how your answers to the quiz match with the experts'. Have you nailed down proper ICD... Read more
Reader Question:
Refer to These ICD-10-CM Guidelines for Chemo Adverse Effects
Question: A patient arrives for an evaluation and management (E/M) visit following chemoth... Read more
You Be the Coder:
How to Code Weekly Injection of Darbepoetin Alfa
Question: A patient who is on chemotherapy treatment for lymphoma, presents for a weekly i... Read more
Infusions:
Untangle Your HCPCS and Multiple Infusion Coding with This Handy Chart
These 3 steps will make a summary of medications. You know oncologists infuse not only ch... Read more
Documentation:
5 Rules You Can Follow to Improve Provider Documentation
Do not assume EMRs are flawless. Documentation compliance is as important as coding accur... Read more
Infusions:
For Infusions, Primary Purpose — Not Medication Sequence — Matters Most
Here are 2 exceptions for when you can report two initial administration codes. Choosing ... Read more
Reader Question:
Distinguish Between Immunotherapy and Chemotherapy
Question: How is immunotherapy different from chemotherapy in treatment of cancer? Ohio S... Read more
Reader Question:
Cause of Vulvar Dysplasia Doesn't Influence Diagnosis Coding
Question: Our oncologist diagnosed a stage 0 vulvar neoplasm. The histopathology report st... Read more
You Be the Coder:
Getting Denied? Pay Attention to Procedure/Diagnosis Linkage
Question: A Medicare patient is receiving Firmagon and Prolia. If he gets these on th... Read more
Chemotherapy:
Clean Up Your Intracavitary Chemotherapy Claims by Busting These 5 Myths
Find out if you can report 96446 for temporary catheters. When your oncologist prescribes... Read more
Billing:
Is Your Oncologist Not Around? Review These Reciprocity Rules
Know the dos and don'ts of reciprocal billing. Every practice has its procedures for prov... Read more
ICD-10-CM:
Go In-Depth With These GIST and Pancreatic Carcinoma Diagnosis Questions
See how you'll navigate terminology in the Alphabetic Index. Oncology coding isn't always... Read more
Reader Question:
File Your Claims on Time
Question: We had a problem with a claim and didn't get it filed with Medicare until over a... Read more
Reader Question:
Narrow Down to 55700 for Transurethral Prostate Biopsy
Question: How can we best report a transurethral biopsy of prostate tissue? Wisconsin Sub... Read more
Reader Question:
Prep Now for New Medicare Cards
Question: Our MAC just told us that patients will be bringing in new Medicare cards starti... Read more
Reader Question:
Diagnostic Codes Apply After Treatment Too
Question: For how long after treatment can we use the cancer diagnosis code C56.9 for a pa... Read more
You Be the Coder:
Investigate Incisions for Bone Marrow Aspiration and Biopsy
Question: Our physician does a bone marrow aspiration and biopsy. Is it correct to report ... Read more
ICD-10-CM:
Generate Picture Perfect Claims by Reviewing This Neoplasm Diagnosis Primer
Make sure you master the exceptions to the rules. Whether you're a seasoned oncology codi... Read more
E/M:
Obliterate Observation Coding Mistakes Before They Happen
Time and language key to code choice. Two code sets. Different location requirements. Len... Read more
Infusions:
Answering These 5 FAQs Will Resolve Your Infusion Claim Concerns
Hint: Make sure the medical record backs up how much time you report. Infusion coding can... Read more
Reader Question:
Attention Billing: Pay Attention to MAC Communications
Question: I've been hearing a lot about CMS's Targeted Probe and Enforcement program since... Read more
You Be the Coder:
Get to the Bottom of This Prolonged Care Service Myth
Question: Can you report prolonged services with any level of E/M code or just the highest... Read more
CCI 24.0:
Prepare to Scratch Your Head at These Confusing Oncology Radiation Edits
New code 38222 means you no longer have to worry about this old edit. January 1, 2018 has... Read more
MACRA:
Avoid a 4% Penalty — Report MIPS 2017 Data Before March 31
Remember you only need report 90 days of data for 2017 to sidestep penalties. Performance... Read more
E/M:
Bust These 5 E/M Myths Before You Make Costly Mistakes
Do you know what counts as established? Find out. Coding advice can come from all sorts o... Read more
Claims and Denials:
Make Certain Your Oncologists Sign Their Orders — Or Else
Don't waste your time appealing a denial due to a technicality. The Medicare Program Inte... Read more
Reader Question:
Delve Into The Difference Between Different PFSH
Question: Can you give me an example of pertinent PFSH versus complete PFSH? Florida Subs... Read more
Reader Question:
Highlight Route for Ovarian Cyst Fluid Collection
Question: In a patient suspected to have ovarian tumor, our physician obtained a sample of... Read more
Reader Question:
Factor in Adverse Effect Guidelines for Conditions Following Chemotherapy
Question: What ICD-10-CM code should I use for a consultation for vomiting following chemo... Read more
You Be the Coder:
Malignant Neoplasm of Main Bronchus
Question: What changes can we anticipate for diagnosis coding for malignant bronchial neop... Read more
Revenue Cycle Management:
4 Steps That Help Your Oncology Practice Win Appeals
Former payer rep reveals the tactics that work. Want to get better at appeals? Take some ... Read more
Revenue Cycle Management:
Use Essential Ingredients for an Appeals Packet That Gets You Paid
Plus, a handy template that will help you write the perfect appeal letter every single tim... Read more
Revenue Cycle Management:
Here's the Financial Report You're Not Reading — but Should Be
Spot and stop hidden billing problems by tracking this number. You might be used to scopi... Read more
Staffing:
Use Smart Staffing Tips for Financial Counseling Program
Lack of training puts counselors, patients in tough position. It is not unusual for cance... Read more
Modifiers:
Voluntary Modifiers: Are They Really Optional?
For best results, think of "voluntary" as "mandatory." Think you got off easy with the re... Read more
Clip 'n' Save:
7 Brachytherapy Insertion Codes that Lack Tx Delivery Counterpart
For correct billing, be sure to include a separate treatment delivery code along with the ... Read more
Reader Question:
Be Vigilant in Payer Contract Negotiations
Question: A couple of our payer contracts are up for renewal soon. Any negotiating tips? ... Read more
You Be the Coder:
Reporting IMRT the Right Way
Question: My coworker says we can bill intensity modulated radiotherapy (IMRT) calculation... Read more
MIPS:
CMS Ups the Ante for Quality Reporting in 2018
Upcoming changes include full-year reporting, increased payment adjustments Are you famil... Read more
MIPS:
The QPP: A Quick Recap for Oncology Reimbursement Professionals
Medicare created the Quality Payment Program (QPP) as part of 2015's Medicare Access and C... Read more
Quality Payment Program:
APMs: The Flip Side of MIPS
The Oncology Care Model APM offers 2 participation options. Smart practices should weigh t... Read more
Revenue Cycle Management:
Boost Your Collections with a Solid Financial Counseling Program
Follow these 4 steps to safeguard a patient's financial and physical well-being. Your pat... Read more
Reader Question:
Simple Formula Reveals Whether Your Practice Can Afford a Financial Counselor
Question: Our doctors won't spring for a patient financial counselor. How can we convince ... Read more
Reader Question:
Use These Metrics to Measure Your Financial Counselor's Job Performance
Question: Reviews are coming up and we added a financial counselor position this year. How... Read more
You Be the Coder:
Get Ready to Append Modifier QQ
Question: We recently added a CDSM module to our EHR to comply with CMS' new rule about ap... Read more