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The Infusion Chemotherapy Coder is responsible for accurate and compliant coding of chemotherapy and therapeutic infusion services in outpatient, hospital-based, and physician office settings. This role requires strong knowledge of oncology infusion coding guidelines, CPT/HCPCS codes, drug administration hierarchies, and payer-specific rules to ensure optimal reimbursement and regulatory compliance.
Assign accurate CPT, HCPCS, ICD-10-CM, and modifiers for chemotherapy, immunotherapy, hydration, and therapeutic infusion services
Code chemotherapy drug administration services, including:
Initial, subsequent, and concurrent infusions
IV push vs. infusion services
Hydration services
Sequential and combination therapy
Apply correct chemotherapy hierarchy rules and time-based coding requirements
Code and validate oncology drugs, including wastage and JW/JZ modifiers when applicable
Review provider documentation for completeness and query when clarification is needed
Ensure compliance with CMS, NCCI, AMA, and payer-specific guidelines
Identify and resolve coding edits, denials, and underpayment trends related to infusion services
Collaborate with billing, auditing, and clinical teams to support clean claim submission
Maintain productivity and accuracy standards in a high-volume environment
Stay current on annual CPT/HCPCS updates and oncology coding changes
CPC, CCS, or COC certification (required)
Minimum 3-4 years of infusion or oncology coding experience
Strong knowledge of:
Chemotherapy and therapeutic infusion coding
Drug administration hierarchy
Time-based infusion coding
HCPCS J-codes and drug units
Experience coding for hospital outpatient, infusion centers, or oncology practices
Familiarity with Epic, Cerner, Athena, or other EHR systems
Excellent attention to detail and strong analytical skills
Oncology-specific coding experience
Experience with audits, charge review, or denial management
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