Extracorporeal Photopherisis (ECP) - CPT 36522

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fjohnson
Posts: 59
Joined: Wed Mar 13, 2013 9:04 am

Wed May 02, 2018 2:40 pm

According to Medicare's NCP, ECP is covered as a second line treatment for certain dx when other treatments have failed. What needs to be documented in medical record to support treatment failure?
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admin
Site Admin
Posts: 451
Joined: Mon Apr 09, 2012 1:54 pm

Mon May 07, 2018 12:10 pm

Good Afternoon-

The documentation to support the failure should be included in each visit that this is assessed, more than likely this will be in follow up visits where this is discussed and a new treatment plan with the ECP is initiated. The procedural note should also also include an indication of previously failed treatments.

Your question has been answered by Stephanie Allard, CPC, CEMA, RHIT
fjohnson
Posts: 59
Joined: Wed Mar 13, 2013 9:04 am

Fri May 11, 2018 5:14 pm

Thank you for the information. Do you have a primary source reference for this guidance? Additionally, if the initial treatment failed in 2016 and the patient is ordered to have ECP several times in 201 & 2018 must the initial failure be documented each time or is it enough that it is documented in the patient's medical record at least once?
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