CAPC Palliative Care Discussion Forum
Billing and Finance
I am a Palliative Care NP employed by a hospital in their outpatient cancer center. Based on CAPC "Billing for Palliative Care Services" recommendations in their published Toolkit, as well as consulting with other outpatient palliative programs, I have been coding using symptom ICD-9 codes along with the V66.7 palliative encounter code.
My hospital coders/billers, citing official ICD-9 coding guidelines, state that I must use the disease specific(cancer) diagnosis in the first position followed by the V66.7 code. They do not list symptom codes at all unless the underlying cause is not known.
To reduce patient burden, I often see patients on the same day as the oncologist. The oncologist is obviously using the disease specific code. I assume my service will not be reimbursed if I also use the same disease specific ICD-9.
Can other outpatient programs share their coding practices and what has been successful for them. Thank You.
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Symptom vs. Disease-Specific ICD-9 codes
Julie PIpke, CPC
CAPC Consultant