Forum - Questions & Answers

Dec 3rd, 2014 - janeanderson 9 

Interleukin Therapy Physician Billing

I'm hoping that someone can give me some direction on how to properly bill for multi inpt visits for an IL-2 patient.

Scenario: Our Hematology/Oncology division has started treating patients with melanoma with interleukin therapy. The patient is admitted to the hospital for IL-2 treatment and is admitted to the hemonc attending team. The HemOnc attending team rounds in the morning and examines the patient. IL-2 patients are complex in nature and requirec close monitoring and later on that same day the HemOnc physician whose specializes in IL-2 Therapy is called in to see the patient due to a change in the patient's clinical condition.

I have advised the HemOnc physcians to use diagnosis V58.12 (encounter for immunotherapy) as their primary diagnosis and report the cancer diagnosis as the secondary diagnosis.

How should the multi inpatient visits be reported? Should each physician bill for their services that day and the coders will have to appeal the services that will get denied for either duplicate services or exceeding the allowable visit per DOS? Or should these additional service(s) be reported with prolonged service codes along with the attending's visit service?

Any guideance in how to properly bill for these services is greatly appreciated.
Thanks in advance
Jane



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