Tip of the week: Consider reporting a V58 code with ESA therapy
APCs Weekly Monitor, August 22, 2008
Want to receive articles like this one in your inbox? Subscribe to APCs Weekly Monitor!
Billers at the University of Texas’ MD Anderson Cancer Center encountered difficulties with local guidance when they reported chemotherapy-induced anemia as a diagnosis with no encounter for chemotherapy. When reporting erythropoietin stimulating agent (ESA) therapy, the facility’s local coverage determination (LCD) required it to report anemia as the diagnosis with a code for the chemotherapy encounter. Billers ran afoul of this LCD when the patient received an oral administration of chemotherapy and became anemic secondary to the regimen, said Angela Simmons, CPA, director of clinical revenue and reimbursement at MD Anderson.
What should you report on the claim for anemia due to oral chemotherapy? The Centers for Disease Control and Prevention told Simmons’ organization that it could report a V58 code (encounters for other and unspecified procedures and aftercare) regardless of the route of administration. Doing so passed the ESA therapy claims through the edits.
(This tip was adapted from Briefings on APCs. To view the entire tip, click here.)
Want to receive articles like this one in your inbox? Subscribe to APCs Weekly Monitor!
Comments
0 comments on “Tip of the week: Consider reporting a V58 code with ESA therapy ”
Related Products
Most Popular
- Articles
-
- Q/A: Volume requirement for reporting hydration services
- Featured blog post: Nurses face felony charges after reporting physician to the Texas Medical Board
- Catch up on what's new with injections and infusions
- Identify potential Medicaid RAC target areas
- HIPAA Q&A: Level of encryption needed for email
- Topic: CMS, OESS post new security compliance review information, checklist
- Capturing all necessary codes for IUD insertion and removal can be challenging
- What does case-mix index mean to you?
- OB services: Coding inside and outside of the package
- QA:Coding multiple initial infusions
- E-mailed
-
- Q/A: Volume requirement for reporting hydration services
- Featured blog post: Nurses face felony charges after reporting physician to the Texas Medical Board
- HIPAA Q&A: Level of encryption needed for email
- Q&A: Follow CMS' coding guidelines when using modifier -25
- What does case-mix index mean to you?
- Catch up on what's new with injections and infusions
- CMS has reformulated payments for some bilateral procedures
- New conflicts of interest create new challenges
- Q/A. One injection code or two?
- ED-to-inpatient transfers are flawed with safety gaps
- Searched