tci Outpatient Facility Coding Alert - 2013 Issue 1

Chemotherapy: Don't Miss These Key Revisions to 96401-96549 Guidelines

One coding example specifically applies to facilities. CPT® 2013 includes nearly half a page of new or revised portions to the chemotherapy administration guidelines. Although a large portion of the guidelines for codes 96401-96549 (Chemotherapy administration …) are marked as revised, only a few changes were made -- but overlooking these could sink your pay for these services. Biggest shift: The AMA revised the language to clarify that any qualified health care professional (not just a physician) may provide the work or monitoring required. The same revision applies to procedures throughout CPT® 2013. Remember: The CPT® code set...

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