Health Information Management

Tip of the week: Consider reporting a V58 code with ESA therapy

APCs Insider, August 22, 2008

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.

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