How To Use CPT Code 1125F

CPT 1125F describes the quantification of pain severity in patients undergoing chemotherapy or radiotherapy for cancer. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples.

1. What is CPT Code 1125F?

CPT 1125F can be used to report the severity of pain in patients with cancer who are receiving chemotherapy or radiotherapy. This code is used to quantify the level of pain experienced by the patient during the measurement period.

2. Official Description

The official description of CPT code 1125F is: ‘Pain severity quantified; pain present (COA) (ONC)’. This code is used to measure and report the severity of pain in patients undergoing chemotherapy or radiotherapy for cancer.

3. Procedure

1. The healthcare provider uses various instruments to quantify the severity of the patient’s pain, such as numerical rating scales, visual analog scales, or verbal rating scales.
2. During each visit, the provider assesses the patient’s pain level and documents the presence of pain and its severity in the patient’s healthcare record.
3. The provider must report this measure at each visit during the measurement year and utilize at least one comprehensive pain screening or pain management plan.

4. Qualifying circumstances

CPT 1125F is used for patients with cancer who are undergoing chemotherapy or radiotherapy. The provider must measure and report the severity of pain experienced by the patient during the measurement period. This code should be used when the patient experiences pain and the provider needs to quantify its severity.

5. When to use CPT code 1125F

CPT code 1125F should be used when a patient with cancer is undergoing chemotherapy or radiotherapy and experiences pain. This code is used to quantify the severity of pain and should be reported at each visit during the measurement year.

6. Documentation requirements

To support a claim for CPT code 1125F, the healthcare provider must document the following information:

• Patient’s diagnosis of cancer
• Specific instruments used to quantify the severity of pain
• Date of the encounter and documentation of pain presence and severity
• Utilization of at least one comprehensive pain screening or pain management plan

7. Billing guidelines

When billing for CPT code 1125F, ensure that the patient is undergoing chemotherapy or radiotherapy for cancer and is experiencing pain. This code should be reported at each visit during the measurement year. It is important to follow the specific guidelines provided by the payer regarding the reporting of this code.

8. Historical information

CPT code 1125F was added to the Current Procedural Terminology system on January 1, 2009. There was a code change on January 1, 2010, to include pain severity quantification for patients undergoing chemotherapy or radiotherapy.

9. Examples

1. A healthcare provider measures the severity of pain in a patient with cancer who is undergoing chemotherapy. The provider uses a numerical rating scale to quantify the pain level during each visit.
2. During a radiotherapy session, the provider assesses the severity of pain in a patient with cancer. The provider utilizes a visual analog scale to determine the level of pain experienced by the patient.
3. A healthcare provider examines a patient receiving chemotherapy for cancer and uses a verbal rating scale to assess the severity of pain. The provider documents the presence of pain and quantifies its severity at each visit.
4. During a follow-up visit for a patient undergoing radiotherapy, the provider measures the severity of pain using a numerical rating scale. The provider documents the pain level and includes it in the patient’s healthcare record.
5. A healthcare provider assesses the severity of pain in a patient with cancer who is receiving chemotherapy. The provider uses a visual analog scale to quantify the pain level and documents it in the patient’s medical record.
6. During a chemotherapy session, the provider measures the severity of pain in a patient with cancer. The provider utilizes a verbal rating scale to determine the level of pain experienced by the patient and documents it for each visit.
7. A healthcare provider examines a patient undergoing radiotherapy for cancer and uses a numerical rating scale to assess the severity of pain. The provider documents the presence of pain and quantifies its severity at each visit during the measurement year.
8. During a follow-up visit for a patient receiving chemotherapy, the provider measures the severity of pain using a visual analog scale. The provider documents the pain level and includes it in the patient’s healthcare record.
9. A healthcare provider assesses the severity of pain in a patient with cancer who is undergoing radiotherapy. The provider uses a verbal rating scale to quantify the pain level and documents it in the patient’s medical record.
10. During a radiotherapy session, the provider measures the severity of pain in a patient with cancer. The provider utilizes a numerical rating scale to determine the level of pain experienced by the patient and documents it for each visit during the measurement year.