Medicare patients

Hi,
Does anybody know where can I get information on what procedures require a doctor on site for Medicare patient? for example do I need to have a doctor in clinic in order to Dc a pump or Hydration (Mc Patients). HemOnc Specialty. Thanks

Medicare patients and infusion services

In Chapter 12 of the Medicare Claims Processing Manual, (Pub 100-04) it states that a physician must be in the office in order to bill an injection code. This leads me to believe that a physician must be in the office for all of the infusion services.

Infusing patients

Yes, a physician MUST be in house. He or she must be on the premises and able to leave whatever he/she is doing and attend a patient. They can be seeing other patients, but not doing something like surgery where he/she cannot leave the patients.

Injection, Infusion and D/c Codes

Actually, for Medicare, all of these services (infusions, injections, and d/c using 99211) are all 'incident to' services and, as such, require that a physician is in the office suite and immediately available.

Bobbi

Medicare pts

Thanks for all the answers but what do you think about this: CMS Manual 104c12 page 29.

Codes for Chemotherapy administration and nonchemotherapy injections and infusions include the following three categories of codes in the American Medical Association’s Current Procedural Terminology (CPT):

1. Hydration;

2. Therapeutic, prophylactic, and diagnostic injections and infusions (excluding chemotherapy); and

3. Chemotherapy administration.

Physician work related to hydration, injection, and infusion services involves the affirmation of the treatment plan and the supervision (pursuant to incident to requirements) of nonphysician clinical staff.

Injections, infusions and incident to

Thanks to all who pointed out that these are all codes that are "incident to" and require a physician in the office. I put a few of them into codecorrect, and the status indicator in the PC/TC field is 5: incident to code.

The supervising practitioner must be in the office to perform the services.