Oncology Coding Article – Outpatient Prospective Payment System (OPPS)

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Medical Oncology Code Changes

Effective July 1, 2007 CMS replaced HCPCS code J1567 with the following product-specific IVIG codes, which are reported with one unit for each 500 mg of product administered:

  • Q4087 Octagam Injection

  • Q4088 Gammagard Liquid Injection

  • Q4091 Flebogamma Injection

  • Q4092 Gamunex Injection

There are also codes available for new payable services such as Rhophylac injections (Q4089) and HepaGam B injections (Q4090). Additional information is available at:

 http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM5635.pdf

In addition, the reimbursement and availability for IVIG is a focus of the Office of the Inspector General in 2007.According to the OIG work Plan: “We will examine current market prices and product availability for Intravenous Immune Globulin (IVIG). As part of this review, we will assess manufacturer pricing and perspectives on IVIG and will also examine other links in the IVIG supply chain, i.e., distributors, Group Purchasing Organizations, and physicians.”

 

This Coding and Reimbursement Update was prepared by:
Cindy C. Parman, CPC, CPC-H
Coding Strategies, Inc.

Phone: (877) 6CODING

Fax: (770) 445-0407

[email protected]
www.codingstrategies.com

Cindy C. Parman, CPC, CPC-Hcparman-4276325
principal and co-founder of Coding Strategies, Inc. in Atlanta, GA. Cindy is a current member of the Advisory Board for the American Academy of Professional Coders (AAPC) and a faculty instructor for AMA Solutions, a subsidiary of the American Medical Association.  She serves as the Consulting Editor of the Radiology Coding Alert and is on the Editorial Advisory Board of General Surgery Coding Alert and Pain Management Coding Alert.  

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