Oncology Coding: Specific Codes to Get Your Doctor’s Documentation - By: Julia Rose

Your provider’s documentation must offer the details you need to choose among the new codes. To do correct oncology coding, the trick is finding the middle ground between the doctor not documenting enough information and making his documentation so specific that you have a hard time choosing the most appropriate diagnosis code.

Here’s what you can do for a proper oncology coding: Once you get the final list of new codes, give your providers a job aid with the more specific codes. Your doctors may not know what information you need for each diagnosis, so you can show them the detail you need and point out that documenting those specifics helps you do your job more efficiently and helps satisfy payers when they ask for medical records. The provider’s documentation should offer enough detail to allow you to choose among the following fifth-digit options:

• 0--unspecified site, extra nodal, and solid organ sites

• 1--lymph nodes of head, face, and neck

• 2--intrathoracic lymph nodes

• 3--intra-abdominal lymph nodes

• 4--lymph nodes of axilla and upper limb

• 5--lymph nodes of inguinal region and lower limb

• 6--intrapelvic lymph nodes

• 7--spleen

• 8--lymph nodes of multiple sites.

Each type of lymphoma may require different treatment, so with these new, more specific diagnosis codes, you’ll have to be more careful to align each treatment with the appropriate diagnosis code. Oncology coding can be much simpler and denial-free if you and your doctor can do this simple mental coordination.

Tip you can use: When you get the official list of new codes, type up a list for each coder in your department to post on his/ her desk or computer as a reminder. And be sure you update your software system to alert you if you try to use a deleted code.

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