tci Part B Insider - 2005 Issue 9

ONCOLOGY: Split Chemo Claims Tear A Hole In Your Reimbursement

Cancer providers need to bill more codes than one claim can handleA software glitch could be causing delays and costly denials for oncologists.The problem: At some point during claims processing, carriers' systems are splitting single claims into two or more claims - and this is causing denials and hold-ups. Because oncologists have to bill for new chemotherapy administration codes, drug codes, E/M visits, and the new chemotherapy demonstration project codes, the risk of carriers splitting claims is pretty high, say experts. The split claims are causing trouble in a few ways: If you bill using a not otherwise...

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