ED Coding & Reimbursement Alert - 2005 Issue 9
ONCOLOGY: Chemotherapy Payments Trickling In? Here Are A Few Tricks To Help
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Article Overview
This oncology billing article explains a claims-processing problem affecting chemotherapy payments and summarizes operational guidance from a Medicare Part B carrier, oncology consultants, and CMS-related discussions. It is aimed at oncology coders, charge-entry staff, billing managers, and practices dealing with chemotherapy reimbursement delays, claim splitting, and submission workflow issues. The article covers carrier guidance, claim-line ordering, handling of unlisted drug reporting, paper claim submission considerations, and a modifier-related reminder for infusion billing.
Why This Topic Matters
It helps oncology practices understand why chemotherapy claims may be delayed and what general submission practices are being discussed to reduce claim splitting and payment disruptions.
Article Sections
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Claims-splitting problem affecting chemotherapy billing
An overview of the payment and processing issues affecting oncology claims and the general concerns raised by providers and carriers.
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Try One of These Winning Strategies
A set of broad workflow and submission approaches discussed for reducing claim-splitting disruptions in oncology billing.
What You Will Learn
- Why chemotherapy claims may be delayed in current processing workflows
- What broad claim-submission issues are affecting oncology practices
- What kinds of carrier and CMS-related guidance are being discussed
- How billing workflow and claim organization are being addressed at a high level
- What general topics are involved in handling unlisted drug reporting and paper claims
Who Should Read This
- Oncology coders
- Medical billers
- Charge entry staff
- Revenue cycle managers
- Oncology practice administrators
Codes Discussed
Modifiers Discussed
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