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    Wiki Testicular Lymphoma

    What is the correct coding for testicular lymphoma -- I am torn. I have always been told to code any reproductive organ cancer to the disease site. But I am unsure when it comes to lymphoma. This is Diffuse large B-cell lymphoma. I have referred to the official guidelines, and can't find any...
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    Wiki Radiation Weekly Management charge 77427 - Humana PPI audit

    We have been getting PPI audits from Humana that are recouping payments for the 77427 (weekly mgmt charge) because we bill it on the first of the 5 days of treatment. Humana is saying it has to be billed on the 5th day of treatment - but they also require a date span, which our software won't...
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    Wiki Series billing chemo

    Does anyone out there bill their OP chemo on series accounts (monthly billing). It doesn't meet the CMS requirements, but you can bill it that way. I'm curious what it has done as far as reimbursement. Also curious on the denial rates - and if it seems to affect cash flow. We currently bill...
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    Wiki Surgical documentation question

    I have a situation where two physicians performed a complex surgery. One was the primary surgeon, the other is the assistant surgeon. My problem is the only operative report was done by the assistant surgeon. He does list himself as the assistant surgeon in the dictation. There is no...
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    Wiki Humana capping 77300 - radiation oncology

    Anyone else have issues with Humana capping dosimetry charges at 6 units per course of treatment? When we do Vaginal HDR dose calcs are done with each insertion but they only want to pay for 6 total????
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    Wiki Interoperative Frozen section - 88331

    Looking for some advice on billing the 88331 (interoperative frozen pathology). Our surgeon (oncology) will often have to send a specimen to review during the surgery. Is this CPT 88331 billable by the surgeon, or is it only billable by the pathologist. We are getting denials, asking for a...
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    Wiki 77300 - humana capping units??

    Does anyone have an opinion on the fact that Humana's new policy caps the dosimetry charges (77300) at 10 units total in a 58 day period? Our Rad Onc's usually bill this twice - once with the initial course, and again on the boost (when we do a separate plan). We are getting a lot of denials...
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