Oncology Coding: Hcpcs 2011 Shows The Door To J9080-j9097

By Author: Angela Martin
Total Articles: 205
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HCPCS 2011 code-set reveals some deletions, streamlining your drug coding choices. And among the affected drugs are Cisplatin, cyclophosphamide, and vincristine.


The latest changes should simplify billing, moreso if the system your practice or facility uses, such as Pyxis or Lynx, limits you to a single code and billable unit for a drug.


What you should watch out for: These changes have a positive side, but then there are always considerations that will spring up. For instance, if your practice uses different vial sizes, you will need to be alert for the different and specific national drug code (NDC) numbers for the agent dispensed to the patient when you send a claim to a payer who requires national drug code information.


Stick to J9060 for Cisplatin


Cisplatin, ordered particularly for patients with metastatic testicular or ovarian neoplasms, or advanced bladder cancers, is one of the many agents impacted by the HCPCS 2011 code changes.


Revise: HCPCS 2011 makes a small wording revision to J9060.


2010: J9060 -- ...
... Injection, cisplatin, powder or solution, per 10 mg
2011: J9060 -- Injection, cisplatin, powder or solution, 10 mg.


Delete: Code J9062 (Cisplatin, 50 mg) will no longer be available for use in the new year.


Result: You should go for J9060 to report cisplatin, brand name Platinol, when supplied for 2011 dates of service (DOS).


For further details on this and to learn how other codes will bring you instant denials to your oncology practice starting January 1, sign up for an audio conference.