If you think you have lots of time yet to perform ICD-10 testing on your Radiation Oncology coding, billing and collections, think again. CMS will not be performing end-to-end testing of ICD-10-CM and PCS fee-for-service. That means there’s added burden that rests squarely on your shoulders—unless you have an independent, third party medical coding and billing partner with special expertise in the ICD-10 transition. It’s time to re-examine where you are in the process, and if additional support is needed to help you prepare and allocate adequate time to perform all the testing steps necessary to assure your readiness by Oct. 1, 2014.
During your ICD-10 preparations and testing, it is important to pay particular attention to characters 3-6, as these specify the radiation, treatment type, modality and radioactive isotope.
There are now seven characters in an ICD-10-PCS code, which is broken down as:
Character 1 Section
Character 2 Body System
Character 3 Root Type
Character 4 Treatment Site
Character 5 Modality Qualifier
Character 6 Isotope
Character 7 Qualifier
For radiation oncology services, the first character is “D.”
Character selection includes:
Character 3 (Root Type) — Specifies the basic modality (beam radiation, brachytherapy, stereotactic radiosurgery, and other radiation).
Character 4 (Treatment Site) — Specifies the treatment site that is the radiation therapy’s target location.
Character 5 (Modality Qualify) — Further specifies the treatment modality, which includes photons, electrons, heavy particles, and contact radiation.
Character 6 (Isotope) — Describes the radioactive isotope administered in the oncology treatment.
The following example puts this all in perspective:
You receive a claim that describes brachytherapy of the prostate with high dose rate (HDR) using Cesium 137. In ICD-10-PCS, how should you report this?
Answer: DV1097Z.
What’s the take away? If you’re not well on the road to being ready for this transition, the time is now to have the most experienced radiation oncology medical coding and billing team in place to help ensure your smooth transition. It’s times like these, when ICD-10 is looming overhead, that you might need to rethink your ICD-10 process and your medical coding, billing, and collections.
Revenue assurance and ICD-10 expert revMD.com is ahead of the game. They’ve already begun the ICD-10 transition and training process and have an in-depth understanding of the unique nuances of Radiation Oncology coding including the need for uninterrupted patient care and revenue flow. It takes the special expertise of an independent partner in Radiation Oncology medical practice billing to take the weight off your shoulders and ensure your seamless coding transition so you can stay focused on your true passion… caring for patients.
revMD.com is the results-proven alternative for healthcare revenue cycle management, with a niche specialization in Radiation Oncology medical coding and billing that generates unprecedented results and builds profitable medical practices. Not only is revMD.com the industry expert in physician coding, billing and collections, they are the professionals for seamless ICD-10 implementation. Leveraging a history of industry wide success spanning 26 years, revMD.com partners with medical practices throughout the U.S. to optimize revenue for hospital based and practice based physicians. For more information, visit www.revmd.com.