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Oncology & Hematology Coding Alert

HCPCS Update:
Not Coding For Daratumumab Yet? Update Your HCPCS Code List
You can only claim for combination therapy with daratumumab. Breaking news: daratumuma... Read more
ICD-10-CM Update:
Narrow Down To K13.3 For Hairy Leukoplakia
You can’t think leukoplakia for K13.3; don’t forget additional codes that ap... Read more
Quick Review of Hairy Leukoplakia Basics
Here are some basic features of hairy leukoplakia that you can bank upon when reading th... Read more
E/M Guide:
Find Answers For Your Key E/M Challenges And Keep Your Payment Flowing In
Tip: Check the three-year rule for established patients. Your practice probably reports E... Read more
Reader Question:
Check Laterality for Hearing Loss
Question: Our physician documented a diagnosis of mixed hearing loss in a patient who wa... Read more
Reader Question:
Check E/M components for New vs Established Patients
Question: We are reporting an E/M encounter for a follow-up patient when our provider... Read more
You Be the Coder:
Target Q9981 for Rolapitant
Question: How can we code for rolapitant? Was there a recent update on coding for t... Read more
Coding Strategy:
Doctor Prescribing Venetoclax for CLL Patients? Here's What to Submit
Keep documentation for patient selection and any prior treatment. Have you been coding ac... Read more
News You Can Use:
ASTRO Makes Clear Recommendations For Justified RVUs In 2017
Arbitrary crosswalks may mislead; RUC recommendations should be considered. Are you curio... Read more
CMS Announced End To Flexibilities Beyond Oct. 1, 2016
Practices have no option but to adopt specificity and accuracy. ICD-10-CM codes apply ... Read more
ICD-10-CM Update:
Look Beyond Cancer Diagnosis Codes To Capture All Complaints
Fatigue and malaise may not be clearly differentiated but they have separate codes. Wa... Read more
Reader Question:
Split Services Mandate Same Patient and Same Date
Question: Is a common date of service mandatory for split visits? Do visits in outpat... Read more
Reader Question:
Never Ignore Carrier State Confirmation
Question: Our physician has documented a family history of thalassemia carrier stat... Read more
Reader Question:
Follow-up Care is Key to Xofigo Coding
Question: In a patient with advanced resistant prostate cancer, our oncologist admi... Read more
Reader Question:
Counselling Time Determines E/M Coding
Question: How can we effectively report for counselling services of our provider? I... Read more
You Be the Coder:
Confirm Chemotherapy in High-Risk Medication
Question: Our physician is treating a pregnant woman with chemotherapy. This is cle... Read more
CPT® 2017:
CPT® 2017: Prepare To Code For Computer-Aided Detection During Mammography
You can anticipate reforms in mammography, prostate antigen assays, and influenza vaccine ... Read more
ICD-10-CM Coding:
Make Your Way to Clean Claims for Cutaneous T Cell Lymphomas
Check site of lymph nodes; distinguish mycosis fungoides vs. Sézary disease. Cu... Read more
Define Mycosis Fu ngoides and Sézary disease
Check atypical cells in blood and lymphadenopathy in patient with a suspected red rash. ... Read more
Coding Quiz Answers:
Rate Your Coding Know-How for Radiation Therapy Claims
Tip: Limit code 77387 to the technical component of all imaging guidance. In the last iss... Read more
Reader Question:
Differentiate Testicular and Scrotal Pain
Question: Our physician has documented pain in testicles and has not arrived at a d... Read more
Reader Question:
Make Your Way to E/M Codes for Established Patients
Question: We are reporting an E/M encounter for a follow up patient with Hodgkin&rsqu... Read more
Reader Question:
Check Mode of Radiation for Erectile Dysfunction
Question: A patient with prostate cancer was diagnosed erectile dysfunction followi... Read more
Reader Question:
Turn to 77334 for Cushions and Foams
Question: Can we use code 77334 for cushions used during radiation therapy? Flori... Read more
You Be the Coder:
ICD-10-CM Offers Specificity for Hyperplastic Prostate Enlargement
Question: Are there any recent changes in the diagnosis codes for urinary tract sym... Read more
Transfusion Coding:
Follow These Essential Tips To Clean Up Your Autologous Blood Claims
Differentiate collection and transfusion services; check for outpatient setting. Blood tr... Read more
ICD-10-CM Update:
Mark These New Codes for Mast Cell Activation Disorders
Make sure you have documentation for primary, secondary, and other mast cell disorders. ... Read more
Coding Quiz:
Take This Quick Quiz to Assess Your Understanding For Radiation Therapy
Intensity, lesions, ports, and imaging are key. Radiation treatment delivery can make ... Read more
Reader Question:
Specify Need for Transfusion Pump
Question: Does Medicare provide coverage for transfusion pumps? What are the indica... Read more
Reader Question:
Confirm Laterality for Ovarian Cyst in 2017
Question: What are the diagnosis code changes anticipated for ovarian cysts in 2017... Read more
Reader Question:
Earn for Mediport Flush
Question: A patient with reticulolymphosarcoma in the inguinal lymph nodes presents f... Read more
Reader Question:
Include Counseling in E/M with Proper Documentation and Rationale
Question: What is the counseling exception, and what does it means for coders? Can ... Read more
Reader Question:
Size and location of Foot Tumor are Key
Question: Our physician did a resection for a tumorous growth on the foot. How can ... Read more
You Be the Coder:
Pick Up Correct HCPCS Code for Leukocyte Reduced Platelets
Question: What is leukocyte reduction? Our physician documented leukocyte reduction... Read more
Coding Strategy:
4 Tips Help You Master Your Malignant Melanoma Claims
Look for specific codes for biologicals, interleukins, and other chemotherapy options. ... Read more
Treatment Planning:
Follow This Advice To Plan And Prepare For Radiotherapy
Earn for 3-D planning, dosimetry calculation, and IMRT. Radiotherapy planning and prep... Read more
Medicare News:
2017 Will Introduce Reforms For Billing Modifier JW
Caution: JW modifier is only for single-use vial or package drugs and biologicals. Mod... Read more
Reader Question:
Count Patches for Allergy Testing
Question: Our physician performed a patch test for allergy testing. How can we repo... Read more
Reader Question:
Modifier QW Implies CLIA Waiver
Question: We have recently received clinical laboratory improvement amendments (CLIA)... Read more
Reader Question:
Fatigue and Asthenia are Not the Same
Question: In a patient with confirmed cancer, our oncologist documented fatigue. Ho... Read more
You Be the Coder:
Differentiate Collection and Transfusion of Autologous Blood
Question: How can we bill for outpatient autologous blood transfusions? Are there d... Read more
ICD-10-CM Update:
New in ICD-10-CM: Look For Not One But Many Changes
Proposed changes add new gastrointestinal stromal tumor and encounter codes. In the pr... Read more
CCI 22.1 Review:
Apply CCI Edits For Spotless Clean Claims
Reporting 99363, 99364, or G0250 with these inpatient E/Ms will trigger a denial. The Cor... Read more
Billing Corner:
Follow Expert Advice For Smart 'Incident to' Billing
Identify NPP services, describe direct supervision, and check payer guidelines. &lsqu... Read more
Reader Question:
Duration of Service and Payer Policies Influence Observation Coding
Question: A patient with hematological malignancy was given chemotherapy subsequent... Read more
You Be the Coder:
Biopsy Alone Confirms Diagnosis of Malignant Bladder Tumor
Question: Our oncologist treated a patient for suspected bladder cancer. The diagno... Read more
Biopsy Basics:
Biopsies: Think Beyond Skin For Precision In Skin Biopsy Coding
Narrow down to site of biopsy for the most accurate codes. Site specificity is key to ski... Read more
ICD-10-CM Update:
News: Pick Up Cues From Changes Proposed For Upcoming Annual Update In ICD-10-CM
Prepare to implement revisions in your Hodgkin lymphoma diagnosis coding. The CDC has ... Read more
Sneak Peek:
Types of Hodgkin Lymphoma
The World Health Organization (WHO) classifies Hodgkin lymphoma into 2 main groups: ... Read more
E/M Refresher:
Define ROS Before You Make Your E/M Decision
Focus on problem-related ROS and keep a count of all systems examined. Oncology review... Read more
Reader Question:
Do Not Exceed Allowed Yearly Screening for G0475
Question: Our physician includes HIV screening for patients reporting for treatment... Read more
Reader Question:
Watch the Bundles Before You Report Modified Barium Swallow
Question: What is a modified barium swallow? Is there a specific code for reporting... Read more
You Be the Coder:
Earn for Contrast Injections in Cyst Examinations
Question: Our physician injected contrast into a cyst via a previously placed cathete... Read more
Coding update:
Scrutinize Your Practice For Recent Reforms To Avoid Payment Delays
Diagnosis code F17.2 will go into effect July of this year. Oncology coding has undergone... Read more
Gel Spacers For Prostate Cancer Management
The use of gel spacers is a recent advance in the management of prostate cancer. Your phys... Read more
News You Can Use:
CMS Announces Deletion of Edit for 77300 and 77295
The deletion will retroactively apply to claims effective Jan 1. Facilities providing se... Read more
ICD-10-CM Update:
Diagnosis Coding: Do Not Default For These 3 Common Central Benign Tumors
Pituitary, pineal, and carotid body tumors have individual discrete codes. The most co... Read more
Basics of Carotid Paragangliomas
More than 60% of paragangliomas in the head and neck region arise in the carotid bodies.... Read more
Reader Question:
Understand Services Inclusive in Preventive Care Visits
Question: A 50-year-old new male patient who had a strong family history of cancer, r... Read more
Reader Question:
Hit the Correct Diagnostic Test for Histoplasmosis
Question: In a patient with carcinoma and suspected to have a histoplasmosis infect... Read more
You Be the Coder:
Differentiate Bone Marrow Harvesting and Sampling
Question: How can we report bone marrow harvesting? Do the codes for bone marrow sa... Read more
Coding Quiz:
HCPCS Coding: Find out how much you know about J codes
Target right code and correct quantity of drug administered. Reporting HCPCS level II ... Read more
Coding Strategy:
Flu Vaccines: You Can Earn For Influenza Code 90630
CMS had fixed a payment of $23.467 for the 2015-2016 flu season. The CPT® added a new in... Read more
ICD-10-CM Update:
ICD-10-CM: Focus On Two D Codes For Unspecified Benign Neoplasm Of Mouth
Pay attention to ‘other’ versus ‘unspecified’ distinction. Whe... Read more
Test Your Understanding For Common J Codes in Hematology And Oncology
To earn for the whole quantity of drug, keep a precise count of units to be reported. ... Read more
Reader Question:
Size Is Key for Laser Ablation of Bladder Tumors
Question: Our physician used laser ablation for the management of a tumor in the ur... Read more
Reader Question:
Determine if ACP was component to AWV
Question: Our physician does advance care planning for various patients. How can we r... Read more
Reader Question:
Ensure All Documents Bear Physician Signatures
Question: What are the necessary requirements for physician signatures? Are E-signa... Read more
Reader Question:
Catheter Cost Is Included In 51702
Question: For a patient with a urinary catheter, can we bill for the Foley itself w... Read more
Reader Question:
Target 87804 for Office Flu Tests
Question: How can we code for immunoassay tests for influenza? Is it incorrect to sub... Read more
You Be the Coder:
Count Number of Injections in Allergy Immunotherapy
Question: How can we report allergy immunotherapy? Can we also report the examination... Read more
2016 Update:
Understand These Basics Before You Can Bill for Advance Care Planning
Submit codes 99497 and +99498 on the same date as chronic care management, and in global... Read more
Beneficiaries Seek Benefits In Advance Care Planning Services
Last year, the Kaiser Family Foundation conducted a survey prior to the release of final... Read more
Screening Refresher:
G0472: Do Not Miss Payment For Hepatitis C Screening
Reserve repeat annual screening only for the high risk patients. When your physician s... Read more
HCPCS Update:
Update How You Report Keytruda® and Cryamza, Thanks to 2016 Changes
Prepare to include J9271 and J9308 in the list of your chemo codes. Here are two key H... Read more
Indications, Formulations, Dosage and Administration of Pembrolizumab and Ramucirumab
Pembrolizumab Indications: Pembrolizumab is used in metastatic NSCLC that expresses PD... Read more
Reader Question:
Submit Only One Code for Infusion, Injection, and Hydration
Question: It is possible to bill for non-chemo infusion 96365 and 96367 and hydrati... Read more
Reader Question:
Submit 1 unit of J3430 for Every mg of Vitamin K
Question: In a patient with bleeding disorder, our physician administered an inject... Read more
Reader Question:
Procedure Codes Include Preparation
Question: In a patient planned for a biopsy, our physician did an evaluation for ab... Read more
You Be the Coder:
Confirm Severity When Coding Dysplasia of the Prostate
Question: Our physician documented dysplasia of prostate for an elderly patient. Ho... Read more
Procedure Focus:
Answer These Top 3 Questions To Test Your Understanding of Chemotherapy Administration
When reporting multiple infusions, choose initial administration service code to represe... Read more
News You Can Use:
Discover More About The Medicare Drug Spending Dashboard
Learn more about prescribing trends, drug utilization; do not expect to see price conces... Read more
Anticipate Updates on Oncology Care Model Soon
Notifications may be on the way if you submitted LOI. You can soon anticipate a notifi... Read more
Modifier Trends:
87804: Check Number of Flu Strains Before You Append Modifier 59
Confirm CLIA certification for your practice; document influenza strains A and B. The... Read more
Reader Question:
Too Many Modifiers? Check Modifier 99
Question: We have a small practice in a designated health professional shortage are... Read more
You Be the Coder:
Separate Cancer Screening and Diagnosis
Question: Our physician often does colonoscopy, barium enema, occult blood tests, a... Read more
Coding Guidance:
2 Tips Prepare Your Platelet Transfusion Claims for Success
2 Tips Prepare Your Platelet Transfusion Claims for Success Heads up: Bill one unit of... Read more
Make Medical Necessity a Mandate in Platelet Transfusions
Make sure the physician documents why the platelet transfusion was done. Platelet replac... Read more
2016 Update:
Don't Be Surprised with the Plethora Of Changes in Vaccine Codes
Mark revisions, although these may not be major. Vaccine codes are anticipated to freq... Read more
Top Two Facts To Help You Tackle Vaccine Coding Challenges
One code isn’t enough and age of the patient matters. Immunizations, which are s... Read more
CMS Celebrates ICD-10 Transition Success
MACs make demand for signatures on appeals. Practices have experienced the tra... Read more
Medicare's New Billing Software
CMS is offering free billing programs that will allow you to electronically submit your ... Read more
Reader Question:
Bill Shared Visits to Physicians
Question: Can we bill split visits by physician and NPP as service by the physician? Doe... Read more
Reader Question:
Describe Adverse Events for Chemotherapy
Question: Our physician has documented chills as an adverse event during administra... Read more
Reader Question:
Confirm Smallest Surgical Margin for Excision of Melanoma
Question: Our oncologist documented an “excised diameter” of 11 cm by 3... Read more
You Be the Coder:
Earn for Every Milligram (mg) of Rituximab
Question: A patient of chronic lymphocytic leukemia received rituximab 679 mg through IV... Read more