Medical Oncology Code Changes
ACOA Coding Minute
Which Doctor?
The
guidelines on completion of theCMS-1500 claim form total 78 pages of
instructions, and are listed at:
http://www.cms.hhs.gov
These instructions provide step-by-step and
field-by-field instructions for paper and/or electronic claims filing.
Whether the claim is submitted by a third party billing company or by the
provider’s office staff, the information must be correct and complete. One
item that affects oncology practices is the directive for the completion of
field 24k (Reserved for Local Use):
“Enter the PIN (the NPI will
be used when implemented) of the performing provider of service/supplier if
the provider is a member of a group practice. When several different
providers of service or suppliers within a group are billing on the same
Form CMS-1500, show the individual PIN (or NPI when implemented) in the
corresponding line item. In the case of a service provided incident to the
service of a physician or non-physician practitioner, when the person who
ordered the service is not supervising, enter the PIN (or NPI when
implemented) of the supervisor in
item
24k.”
Based upon these guidelines,
the physician who was present supervising the delivery of radiation each day
is listed on the corresponding line item for that delivery code. For
example, if Dr. A supervised treatment delivery Monday, Wednesday and
Friday, and Dr. B was the physician on site for Tuesday and Thursday, there
would be a different PIN number listed for each treatment delivery line to
represent the physician who was actively supervising therapy.
It is important to
recognize that these claim form completion requirements do not affect
hospital charges reported on the UB92 form, but only services performed and
billed in the office or freestanding center.
Watch for more 2005
coding changes in the upcoming months. Review previous Coding and
Reimbursement Updates from the
Academy's Website.
This Coding and
Reimbursement Update was prepared by:
Cindy C. Parman, CPC, CPC-H
Coding Strategies, Inc.
Phone: (877) 6CODING
Fax: (770) 445-0407
Cindy.Parman@codingstrategies.com
www.codingstrategies.com
Cindy
C. Parman, CPC, CPC-H
principal and co-founder of Coding Strategies, Inc. in Atlanta, GA. Cindy
is a current member of the Advisory Board for the American Academy of
Professional Coders (AAPC) and a faculty instructor for AMA Solutions, a
subsidiary of the American Medical Association. She serves as the Consulting
Editor of the Radiology Coding Alert
and is on the Editorial Advisory Board of
General Surgery Coding Alert and
Pain Management Coding Alert.
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