tci Medicare Compliance & Reimbursement - 2005 Issue 3

Oncology: Drug Admin Codes Hit With Thousands Of Edits

Prepare to justify using E/M codes with hydration or chemotherapy.The new drug administration codes that Medicare introduced for 2005 may help physicians obtain a fair payment for their work in administering chemotherapy and other tough medications to patients. But good luck billing them alongside other procedures unless you can justify using a modifier.For example, G0345 (Hydration therapy, first hour) and G0347 (Therapeutic/non-chemotherapy, first drug, first hour) will each become components of a shocking 5,687 codes. You'll be able to override all those edits with a modifier, except for ones bundling the two "G" codes with stereotactic...

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