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Oncology & Hematology Coding Alert

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 the same day, we have been billing J9155, J0897, 96402, and 96372 with modifier 59. Medicare is not paying on the 96402, but the codes are not bundled according to the latest edits I've seen. I'm reporting diagnoses M85.9, C61, and Z79.899. What is the correct way [...]