Medical Oncology, Hematology & Infusion Centers
Cancer is a disease that has been around for centuries with the earliest recorded cases in ancient Egypt during 3000 BC. Treating cancer with chemicals has been a technique used since the time of ancient Greeks. Systemic therapy is the use of drugs that travel throughout the body to eliminate cancer cells. It includes chemotherapy, a drug treatment that uses powerful chemicals to destroy fast-growing cells in the body. Chemotherapy is most commonly used to treat cancer. Since some drugs may work better together, chemotherapy might include the administration of more than one agent. Retaining comprehension of this process is extremely important in the Revenue Cycle
Being knowledgeable of the delivery method of chemotherapy is crucial in submitting correct claims as well as knowing the difference between bundled and packaged claims to avoid loss of revenue due to incorrect coding.
Chemotherapy may be administered in multiple different ways:
There are two kinds of pumps used to control the rate of chemotherapy administration through a catheter:
- Intramuscular (IM), Subcutaneous (SQ), or Intralesional (IL) Intravenous injection (IV)
- By catheter
- Intrathecal Delivery though a device called an Ommaya reservoir
Certified Medical Coding Professionals
Physicians, infusion centers and oncology departments are required to submit correct CPT codes with the corresponding ICD-10-CM code in order to receive optimal reimbursement from the insurance payors. PMSI has the expertise required to correctly and compliantly bill these services for maximum reimbursement. Our Medical Coding Professionals are certified in Hematology and Chemotherapy Coding. They understand CCI Edits, Medically Unlikely Edits (MUE’s) and when it is appropriate to add modifiers. Also, they know and follow the process for Therapeutic infusions and injections and possess and complete understanding on how to charge for injections, hydrations, therapeutic drug administrations and are fully capable of determining the correct CPT and HCPCS codes. Quality control assessments are performed regularly to ensure the coding is completed perfectly.
Understanding and following medical coding guidelines is imperative to avoid denials and receive appropriate revenue. PMSI is here to help make the coding process simple, efficient, and beneficial for you.