Research/Study patients

Here in our practice we partake in study/research programs for our patients. If they qualifiy for a particular study, they are then put on a regimin derived from the drug/study company and this needs to be followed here at the practice. Example, pt is on a prostate cancer study- the study regimine calls for every week H & P, certain labs and once a month a CT scan. These services are billed billed to the research/study company and we are then reimbursed by them and nothing is billed to the insurance company. But there are time that the patient needs to come in for other reasons, maybe a sick call and meds and other services that we will be providing for the patient on that day is not covered by the study so this will then be billed to the insurance company.

My question is if we perform these services do we HAVE to report on the claim to the insurance company using the V70.7 dx and Q1 mod that the patient is on a study?

I know that if the study/research company supplies us with a drug, we don't charge for the drug as they pay for that, but we do charge for the administration of the drug and we do report those codes along with the cancer dx, but do we HAVE to report them on say and EKG that isn't listed on the regimine provided and is going to be sent to the insurance compnay?

As I read it

No, you do not if the service is totally unrelated, like HTN treatment or DM treatment o if these diseases were present and unrelated to the disease under study. These are not "Routine Services" that are used for the direct management of the patient in the study. So a CMP required every 4 weeks for the study would require the code, a CMP for HTN done when a test is not mandated by the study would not.

Your last paragraph makes no sense to me...

Research/study patients

The last sentence was basically just asking if I had to add the V70.7 and Q1- thank you for your help!