neoplasm question...

Hello-

Patient comes in and sees our Oncology doc in 2007 and is dx with lung cancer- pt is sent to the Radiation Oncologist for consult for possible radiation therapy. In 2007 they both bill consultations.

We have been following the a patients care, chemo, radiation and so on since....

Patient returns to the office today for a sick call- severe pain- oncology doctor thinks it might be metastic disease- he billes f/u visit for his service and send patient back to the radiation oncologist for opinion on mets. Radiation doctor finds neuroendocrine tumor and bills a consult for his services.

My questions are:

1- Are we billing for the Radiation Oncologist's visit with the lung cancer as primary and now the mets secondary- or because it is a "new" problem and the Radiation Oncologist found the "new" cancer and will be treating the "new" cancer, can the mets be primary?

2- Is it ok to have the Radiation Oncologist bill a second consult on the patient?

Can anyone help me?

Thanks : )

diagnosis

you bill what you are seeing, ex, mets first followed by lung cancer (if still present and being treated). The radiologist can render an opinion on treatment for mets or not, so if documentation supports a consult, it can be billed. Would need to see notes to be sure of accurate billing.