Coding is EXTREMELY crucial in submitting a clean accurate claim. The “9” stands for the 9th Revision Clinical Modification or ICD-9-CM. It is designed specifically for statistical purposes and for the indexing of medical records by disease and procedure
If there is an absence of an ICD-9 or a claim form, a rejection of the claim will occur along with a delay in payment.
In Radiation Oncology, approximately 200 of these ICD-9 Codes are utilized.
If an ICD-9 code ends with a decimal, you may need to carrier it out to a 4th or 5th digit ICD-9. There are also “V” codes also known as Encounter Codes that are not required to be used by our carriers to date. (i.e. V58.0 Encounter for Radiation therapy).
It is the responsibility of the physician to choose the applicable ICD-9 code for each patient, not the billing clerk!!
The billing clerk may choose a code, but the MD treating the patient should approve it!
TIP OF THE WEEK
The ICD-9 code for the actual treatment area should always be placed in the area #21 of the HCFA form in box #1. If a patient returns for a different treatment area, then the new treatment area ICD-9 code will be placed in box #1, and the old code will be placed in box #2.
Example: Carcinoma of the breast with bone metastasis.
| 21. Diagnosis on Nature of Illness or Injury | |
| 1. 198.5 Metastatic Bone | 3.___________ |
| 2. 174.4 Female Breast | 4.___________ |
You must keep track of this from the consult/follow-up billing sheets. If you have any questions or concerns, ask the physician!
