Chemotherapy Administration Coding Guidelines 2022

The Centers for Medicare & Medicaid Services (CMS) recently published revised coding guidelines for CPT codes 90000 – 99999. In this Blog, we shared CPT codes applicable for Chemotherapy Administration Coding and minor updates in guidelines.  Chemotherapy Administration Coding Guidelines 2022 Reporting Initial Service Code The CPT codes 96360, 96365, 96374, 96409, and 96413 describe […]

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Expanded Coverage of Lung Cancer Screening with LDCT

Lung cancer is one of the most common cancers and the leading cause of cancer-related death in both men and women in the United States. This screening is aimed at the early detection of non-small cell lung cancer. On 10th Feb 2022, the Centers for Medicare & Medicaid Services (CMS) announced a national coverage determination […]

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Benefits of Outsourcing Oncology Medical Billing

By its very nature, oncology is one of the more stressful fields of medicine. Physicians are involved in scenarios dealing with life-threatening diseases and complex treatments every day. That means any other work apart from patient care will add stress. This includes administration and execution of oncology medical billing. Annual changes in medical coding, payer-specific […]

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Oncologists should be prepared for E&M service changes in 2021

It is important for all oncologists to be prepared as significant changes to the Evaluation and Management (E&M) codes E/M are into effect from January 1, 2021. Components for code selection were narrowed down to make them more clinically intuitive and to reduce variation among contractors and payers. Elements of MDM affecting coding for an […]

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Delayed Implementation of Radiation Oncology Model

The Radiation Oncology (RO) Model goals to improve the quality of care for cancer patients getting radiotherapy (RT) and move toward an easy and predictable payment system. The Radiation Oncology Model tests whether modality agnostic, bundled, site-neutral, prospective, episode-based payments to physician group practices (PGPs), hospital outpatient departments (HOPD), and freestanding radiation therapy centers for […]

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Key Trends in Value-based Care of Oncology

In the healthcare industry, Value-based healthcare is the new delivery model in which care providers, including hospitals and physicians, are rewarded for helping patients improve their health and are paid based on patient health outcomes. This model has great adoption in Oncology for delivering holistic patient care while driving sustainable cost savings. In this model participating […]

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Billing and Coding Guidelines for Radiation Oncology (Part 2)

Billing and Coding Guidelines (continued…) Treatment devices, designs, and construction may be charged during a course of therapy when documentation substantiates multiple volumes of interest/ports, the use of custom-made devices, and/or the necessity of replacement devices. Providers should bill for devices at the beginning of the treatment course and then may bill again later in […]

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Billing and Coding Guidelines for Radiation Oncology (Part 1)

Major Reasons for Denial Services performed for diagnoses not listed as covered in this policy or for excessive frequency will be denied as not medically necessary. Frequency is considered excessive when services are performed more frequently than generally accepted by peers and the reason for additional services is not justified by documentation. Indications not listed […]

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Benefits of Medical Coding Audits for Oncology Practice

Accurate medical coding plays an essential role in healthcare information management and overall quality of care. Medical coding audits, both internal and external, ensure that healthcare organizations have the proper policies and procedures in place to achieve quality medical coding. Regular audits can reveal inaccuracy issues, such as outdated codes or even fraudulent billing. These […]

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