Is it appropriate to bill an E/M service with a chemotherapy infusion?
Here is how Nancy Maguire answered that question:
If a significant separately identifiable evaluation and management service is performed, the appropriate E & M code should be reported utilizing modifier 25 in addition to the chemotherapy administration or non-chemotherapy injection and infusion service.
If a patient presents specifically for a procedure or service and no separate E/M services are provided beyond those necessary for the procedure being performed, it is not appropriate to assign an E/M code or modifier -25.
Example: A patient is seen in the clinic for chemotherapy infusion. The physician discusses the procedure with the patient. The nurse takes vital signs and prepares the patient for the chemotherapy. Should an E/M code be assigned with modifier -25 along with the chemotherapy infusion code? No, The patient presented specifically for the chemotherapy, and no additional E/M services were provided.
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Be sure and check out this discussion with LaMont Leavitt (CEO of innoviHealth) and Christine Taxin (Adjunct professor at New York University, President of Dental Medical Billing, and Links2Success).
Some of the resources and tools they discuss will help you with your dental coding/billing and education.
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Discussion between innoviHealth CEO, LaMont Leavitt and Guest speaker, Christine Taxin who is an Adjunct professor at New York University, and President of Dental Medical Billing and Links2Success about making sure you have all the right Dental resources needed to succeed in Dental Medical Billing and Coding.
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