Oncology Medical Billing Services
Chemotherapy and infusion where the drug is most of the claim, and one missed authorization costs more than a month of visits.
In oncology the drug is the claim. Administration coding matters, but a single infusion of a specialty agent can exceed the value of a month of office visits — which means a J-code billed in the wrong units, or an authorization that was never obtained, is a loss no volume of clean visit billing recovers.
ZechionMed provides oncology billing for medical oncology and hematology practices, infusion centers, radiation oncology and hospital-affiliated cancer programmes: financial clearance before treatment, administration and drug coding, wastage billing, and denial management on the claims that carry the money.
Financial clearance is where this specialty is actually managed. Authorization, benefit verification and patient responsibility settled before the first cycle is what prevents the losses that cannot be appealed afterwards.
What We Cover
What We Bill
Financial Clearance
Done before treatment, because afterwards there is nothing to recover.
- Prior authorization for regimens and specialty drugs
- Benefit verification and coverage limits
- Authorization tracking against cycles and dates
- Re-authorization before regimen changes
- Patient responsibility estimates
- Assistance programme and foundation coordination
Drug Billing
Units, wastage and NDC accuracy — the largest single risk in the specialty.
- J-code selection and unit calculation
- NDC reporting where payers require it
- Wastage documentation and billing where payable
- Biosimilar and reference product distinctions
- Buy-and-bill versus specialty pharmacy handling
- Drug acquisition cost reconciliation against payment
Administration and Treatment
Time-based and sequence-based coding from the treatment record.
- Chemotherapy administration by route and time
- Hydration and non-chemotherapy infusion coding
- Initial, sequential and concurrent infusion hierarchy
- Injection administration
- Same-day E/M with treatment where supported
- Port access and flush billing where separately payable
Radiation and Related
Treatment planning and delivery on their own coding structure.
- Treatment planning and simulation
- Dosimetry and treatment devices
- Radiation delivery by technique and fraction
- Image guidance where separately reportable
- Weekly treatment management
Where Oncology Loses Money
Drug units miscalculated
J-codes are billed in defined unit sizes that rarely match the vial. A unit error on a specialty agent can exceed the value of dozens of office visits.
Wastage not billed
Where a payer covers discarded drug, the wastage must be documented and billed. Single-dose vial remainders are real cost, and unbilled wastage is unreimbursed cost.
Authorization for the wrong cycle count
Authorization obtained for a number of cycles, treatment continued beyond it. The later cycles deny, and by then the drug has been given.
Infusion hierarchy applied wrongly
Initial, sequential and concurrent administration codes follow a hierarchy. Applied incorrectly, a full treatment day is billed as a fraction of itself.
Regimen changed without re-authorization
A change of agent usually requires new authorization. Continuing under the previous one produces a denial on the most expensive claim in the chart.
Frequently Asked Questions
Because oncology losses are largely unappealable. A drug given without authorization has already been purchased and administered — the money is gone in a way that a coding error is not.
Contact ZechionMed
The Drug Claim, Right the First Time
Financial clearance before treatment, accurate units and wastage, authorization tracked against cycles.
Talk to ZechionMed about oncology billing.