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Oncology & Hematology Coding Alert

Case Study:
J9265 and More Apply to This Ovarian Cancer Scenario
Test yourself by choosing the proper codes and units for this encounter. Finding the p... Read more
180.0-184.0: Pair the Proper ICD-9-CM Code With the Female Reproductive Site
Give your coding a boost by tying code digits to actual structures.Your ability to identif... Read more
99224-99226 Are Reportable by Treating Physician Only, CMS Says
Not coding for the treating physician? Look to outpatient E/M codes.In effect for nearly a... Read more
C50.- Range Will Replace Both 174.x and 175.x
Prepare for more specific codes for male breast cancer patients.ICD-9-CM codes for breast ... Read more
Reader Question:
203.01 Is More Appropriate Than 'History of' Code
Question:  Which "history of" code applies to myelomatosis in remission?Texas Subscri... Read more
Reader Question:
93005 Describes ECG Tech Component
Question: Techs employed by our center perform ECGs on certain patients to check for toxic... Read more
You Be the Coder:
Knock Out This Nasopharyngeal Case
Question: How should I report the following case? A patient presented for chemotherapy to ... Read more
ICD-9 2012:
282.4x Bulks Up Your Thalassemia Coding Options Starting October 1
Pancytopenia, CVC infections, and more land a spot in the update.Although you can get a gl... Read more
CCI Update:
Q2043 Edits Abound in the Latest Round of CMS Bundles
Be sure to check the effective date for these edits.October 1, 2011, brings Correct Coding... Read more
CCI Basics:
Refresh Your Knowledge of How to Legitimately Override Edits
Don't forget the 'same provider' aspect of CCI-bundled codes.Correct Coding Initiative (CC... Read more
C22.- Adds Specificity to Liver Neoplasm Coding
Hepatocellular carcinomas and hepatoblastomas split paths under ICD-10.When you start usin... Read more
Reader Question:
J3430 Applies to Vitamin K
Question:  My physician gave a patient a 10 mg injection of vitamin K. How should I r... Read more
Reader Question:
189.3 Isn't Only Urethra Tumor Possibility
Question: Which ICD-9 code should I use when the doctor documents "tumor of the uroth... Read more
Reader Question:
J9999 Describes Adcetris for Now
Question: How do we code for Adcetris administration? Virginia Subscriber Answer: Accordin... Read more
Reader Question:
99241-99245 Require Face-to-Face Encounter
Question: If our physician only reviews patient records, but doesn't actually examine the ... Read more
You Be the Coder:
Set Aside Uncertain Neoplasm Confusion
Question: I have a physician who wants to use "uncertain behavior neoplasm, breast" instea... Read more
Part 2:
Diagnosis Coding: 285.3 vs. 284.89: Documentation of 'Aplastic' Can Help Steer Your Coding
Discover which condition is more likely to be caused by chemotherapy.Patients with cancer ... Read more
Diagnosis Coding:
6 Tips Help Keep Your ICD-9 Coding on Track
Cheat sheets come with a warning label.To help ensure your coding complies with ICD-9 guid... Read more
153.8 Makes Way for C18.8, Putting the Focus on Overlapping Sites
Anatomic sites will remain important for choosing colon neoplasm codes.Under ICD-9, findin... Read more
Compare 1995 and 1997 Exam Level Guidelines With At-A-Glance Tool
Be sure you choose the single set that's most advantageous to your code choice.With two se... Read more
Reader Question:
Specialty Code 95 No Longer Identifies ADI
Question:  Can you clarify whether we'll need to use specialty code 95 for ADI?Illino... Read more
Reader Question:
79005 and More Saw CCI 17.1 Changes
Question: I've been hearing that a lot of the April CCI nuclear medicine updates changed m... Read more
Reader Question:
'Seen and Agree' Won't Withstand Audit
Question: Our physician works with residents each year. It's very time consuming, but he d... Read more
Reader Question:
Modifier QW Clues Are Available at CMS Site
Question:  We are a CLIA waived lab. How can we find out if a specific test kit is so... Read more
You Be the Coder:
Capture Codes for Rituxan Infusion
Question: How should I code the following case?IV Rituxan, 7:30 AM to 10:30 AM IV Aloxi an... Read more
Part 1:
Diagnosis Coding: 285.22 Scenario Reveals Importance of Following Official Guidelines
Clarify the limits of 'anemia in neoplastic disease,' or risk misrepresenting patient's co... Read more
198.5's Combination Approach Sees a Change Under ICD-10
Be sure documentation clearly distinguishes bone from bone marrow metastases.ICD-10 will d... Read more
CMS Update:
Q2043 Covers More Services Than You May Expect, Says CMS
You'll also want to highlight the need for a second ICD-9 code. A recent Medicare ... Read more
E/M Coding:
3 Questions Get to the Heart of Physical Exam Guideline Options
1995 vs. 1997 guidelines: Limit yourself to one set per claim.Whether you need a quick lin... Read more
Reader Question:
209.76-209.78 Get Ousted From Palmetto LCD
Question: We received notice that our local coverage determination (LCD) for Neupogen chan... Read more
Reader Question:
Q5 Applies to Reciprocal Billing
Question: When one oncologist goes on vacation and a physician from the same group covers ... Read more
Reader Question:
J7185-J7199 May Have Special Units Rule
Question: We've seen conflicting information on reporting clotting factor units to Medicar... Read more
You Be the Coder:
Try Coding Transplant Case
Question: We are treating a patient for a primary lung neoplasm of the right upper lobe. T... Read more
ICD-9 2012:
173.xx Leads List of Proposed ICD-9 Updates for October
See what could be coming down the pike for hemophilia, LEMS, and anaphylaxis, too.With the... Read more
185 and Other Prostate Codes Offer Simple ICD-10 Cross
You'll be able to apply the same PIN rules even when the codes change.If you're comfortabl... Read more
Radiology Services:
71010 and 71020 Denial Prevention Starts With Documentation
Palmetto providers: Add this 'history of' code to the list of covered conditions.If your c... Read more
Learn the Lessons of Palmetto Review
Perhaps because chest X-rays are so common, documentation for these services often isn't a... Read more
Reader Question:
Q2043 Is Effective for Provenge, July 1
Question: Which administration code would match to Provenge?Nevada SubscriberAnswer: Indiv... Read more
Reader Question:
96446 Has MUE of 1
Question: If the patient receives three hours of intraperitoneal (IP) chemotherapy (single... Read more
Reader Question:
349.0 Applies to Lumbar Puncture Headache
Question: The physician documented that following a diagnostic spinal tap, the patient had... Read more
You Be the Coder:
V Codes Feature in Palliative Case
Question: Which CPT®, ICD-9, and HCPCS codes should I use for a 100.2 mg doxorubicin... Read more
ESA Coding:
J0881 and J0885 Are Commonly Reported Codes -- Master Their Uncommon Requirements
Modifiers and test results are among the 'instant denial' triggers for these codes.Whether... Read more
J Codes Dominate Top 10 Codes Reported by Hematologists and Oncologists
See how this list compares to your own reporting statistics.If you want to keep your pract... Read more
D06.- Range Expands Cervical Carcinoma Coding Options
Endocervix and exocervix lesions will have specific codes.When a chart documents cervical ... Read more
8 Questions Help Bulletproof Your HPI Calculations
Get your oncologist to collect the information you need with this handy list.Mastering his... Read more
Reader Question:
36592 Change Supports Previous Use
Question: The 2011 CPT® manual shows that an instruction under 36592 is new. Does it... Read more
Reader Question:
338.3x Can Have Supporting E-Code
Question: The oncologist documented "ringing in head" as a sideeffect of chemotherapy for ... Read more
Reader Question:
+99354 Requires At Least 30 Minutes More
Question: Our physician provided a one hour E/M service, most of which was spent on counse... Read more
Reader Question:
HCPCS Reporting for Patient-Provided Drug Varies
Question: If a patient brings her own medication to the office for administration, how sho... Read more
You Be the Coder:
Decide How to Report Liver and Colon Neoplasms
Question: A patient presents for chemotherapy to treat a secondary liver neoplasm. It meta... Read more
Diagnosis Coding:
338.3 Example Boosts Your Non-Chemo Encounter Coding Savvy
Be sure your coding complies with ICD-9 official guidelines for pain management.If you don... Read more
205.0x Will Be Split Multiple Ways When ICD-10 Arrives
Get a grasp on the extra documentation you'll need for AML coding.Additional required deta... Read more
Modifier GZ Will Yield Instant Denial Starting July 1
Use this table to clear your ABN modifier confusion.Most of the time, when Medicare payers... Read more
HPI Know-How Helps You Catch Level 4 and 5 E/M Opportunities
Beware of CPT® and Medicare differences when counting HPI elements.Not accurately ac... Read more
Reader Questions:
Q2041 Replacement Is in the Works
Question: I just saw that there will be a new VWF HCPCS code in July. Does the fact that i... Read more
Reader Questions:
96450 Covers Spinal Puncture and Infusion
Question: I saw a treatment plan saying the patient will receive chemotherapy by spinal in... Read more
Reader Questions:
10021 Shows FNA Without US
Question: The physician performed the following procedure: Office pelvic ultrasound reveal... Read more
You Be the Coder:
Pick Up on PIN III's Trail in Index
Question: I have a path report that says "PIN III." My problem is that the report also say... Read more
96402 Is Not an Option for Lupron Depot Admin, Noridian Says
Lesson: Don't assume every J9xxx code qualifies for chemotherapy administration codes.If y... Read more
36415 Documentation Should Specify Method to Ease Audit Worries
Follow this advice to be sure your EHR isn't setting you up for trouble.Electronic health ... Read more
276.5x Will See 1-to-1 Correspondence to ICD-10 Options
Watch out for fifth digit changes, though.In 2005, ICD-9 expanded your dehydration coding ... Read more
News Flash:
J9190 and J9395 MUE Issues Should Be Resolved
Remember to watch for denials that Medicare may overturn on appeal.In last month's issue, ... Read more
Reader Questions:
74177 Is Triple-Contrast Possibility
Question: What is a "triple-contrast" CT?Connecticut SubscriberAnswer: Typically, a triple... Read more
Reader Questions:
37202 Takes Col. 2 Spot in Chemo Code Edits
Question: Were there any new CCI edits for chemotherapy in the latest update for physician... Read more
Reader Questions:
99214: Take Discussion with Patient Into Account
Question: Our oncologist spends a lot of time discussing treatment options, imaging result... Read more
Reader Questions:
Learn More About Morphology Code
Question: May I report M8470/1 on the claim form, or do I have to use the neoplasm table?S... Read more
You Be the Coder:
Match Proper Codes to MOPP Claims
Question: Which HCPCS and CPT codes are appropriate for MOPP?Florida SubscriberAnswer: The... Read more
Infusion Coding:
V58.11 Comes First, But Which CPT Codes Does It Match?
Assigning the correct diagnosis pointers is crucial for a successful claim.Choosing the ap... Read more
C67.-Offers Some Good News for the ICD-10 Transition
The new range has the same fifth digits as your ICD-9 bladder neoplasm options.From trigon... Read more
150.0-156.0: Picture Digestive Organ Primary Neoplasm Diagnoses
But remember to watch for contiguous options.If you have trouble distinguishing the cecum ... Read more
ICD-10 Transition Is No Easy Task, Say Those Who've Gotten an Early Start
Best bet: Establish your initial plan for conversion immediately so you can project your p... Read more
Reader Questions:
J9395 MUE Update Slated for April
Question: We've been getting denials for J9395 based on the number of units. Is there an M... Read more
Reader Questions:
569.3 or 578.1? Check Origins of Blood
Question: I'm not sure when I should use 569.3 and 578.1 for bloody stool. Are they one an... Read more
Reader Questions:
209.21 Trumps 162.9 for Carcinoid Tumor
Question: Pathology reports came back indicating a malignant carcinoid tumor of the lung. ... Read more
You Be the Coder:
162.x: OK for Pleural Effusion Case?
Question: Documentation indicates malignant pleural effusion in a patient with malignant c... Read more
Infusion Coding:
96413 + 96365: Is This Pairing Ever Correct?
Try your hand at 2 chemotherapy coding challenges.Coding is all about applying standardize... Read more
202.8x Will Make Way for C85.8- and C85.9-
'Other specified' and 'unspecified' NHL fall under different codes in ICD-10.When you star... Read more
Clip and Save:
162.x Dominates Your Pulmonary Neoplasm Coding Options
See at a glance how codes match to lung anatomy.When your oncologist documents a lung neop... Read more
Practices Collected Over $8 Million in Part B Pay for DOS After Patients Died
Don't let date format confusion lead to refund requests.Part B practices should always be ... Read more
Reader Questions:
92511 and 31575 Depend on Destination
Question: If the oncologist inserts a scope through the nose to examine the larynx, is thi... Read more
Reader Questions:
99211 and 96372 Are Out Without Supervision
Question: There's a note under CPT 96372 that says if there's not direct physician supervi... Read more
Reader Questions:
Modifier KX on PET Claims Explained
Question: We bill the global service for NaF-18 PET scans for bone mets. Are we supposed t... Read more
Reader Questions:
77080 and 77081 on Same Date Offers Challenge
Question: Our center provides DXA screenings for certain cancer patients. We've been getti... Read more
You Be the Coder:
V10 Use Has a Defined Start Time
Question: We have a patient who had a colon resection for cancer over six months ago. Two ... Read more
CCI Update:
96446 Joins the CCI Club With Dozens of New Edits
Watch out: E/M bundles don't always place 96446 in column 1. January means new CPT codes ... Read more
Fee Schedule Update:
Congress Passes Extenders Act to Keep CMS Fees Level in 2011
The Medicare payment 'roller coaster ride' isn't over yet. It's official! President Obama... Read more
C34.- Offers Multiple Options for Main Bronchus Neoplasm
Start preparing now with this new monthly feature comparing ICD-9 and ICD-10. ICD-9 2011 ... Read more
HCPCS 2011:
J0561 Replaces J0560-J0580 as of January 1
Base unit calculations on the updated code definitions, or pay the price. HCPCS codes for... Read more
CPT 2011:
74176-74178: Spotlight the New Abdominal/Pelvic CT Codes
Clear up your 74178 questions with these tips. If your facility provides and codes for CT... Read more
Reader Questions:
ICD-10 Anemia Guidelines in the Spotlight
Question: I read an article that said ICD-10 guidelines for anemia/neoplasm coding differ... Read more
Reader Questions:
99195 Is Specific to 'Therapeutic'
Question: Is there any authoritative guidance on what separates 99195 from 36415? Answer:... Read more
Reader Questions:
99281-99285 Range Doesn't Apply to Phone Call
Question: One of our patients presented to the ER. The ER physician called our oncologist... Read more
You Be the Coder:
153.x Sets You Up for Physician Quality Reporting
Question: I want to be sure I'm reporting PQRI measure 72 correctly for 2011. We use clai... Read more