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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
Anatomy:
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
E/M:
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
ICD-10-CM:
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
ICD-10:
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
ICD-10:
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
E/M:
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
ICD-10:
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
ICD-10:
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
Table:
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
ICD-10:
D06.- Range Expands Cervical Carcinoma Coding Options
Endocervix and exocervix lesions will have specific codes.When a chart documents cervical ... Read more
E/M:
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
ICD-10:
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
Modifiers:
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
E/M:
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
Chemotherapy:
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
Labs:
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
ICD-10:
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
ICD-10:
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
Anatomy:
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:
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
ICD-10:
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
Compliance:
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
ICD-10:
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