billing for office infusion visit

billing for an office infusion visit

Do you have a specific question about this?

If a physician or NPP has a medically necessary visit with the patient on the same day as the infusion, that is a billable service. Medicare says:

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 code. For an evaluation and management service provided on the same
day, a different diagnosis is not required.

Nurse visits, on the other hand, are not separately payable with infusions.

Download from here:
http://www.cms.hhs.gov/manuals/iom/List.asp
Pub 100-04, Chapter 12, Look at 30.5