Medical Billing Coding - E&M with Chemotherapy codes, cpt, codes
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Thread Topic: E&M with Chemotherapy codes
Topic Originator: Deb Peloso
Post Date June 16, 2011 @ 2:59 PM
E&M with Chemotherapy codes


Deb Peloso
June 16, 2011 @ 2:59 PM Reply  |  Email Friend   |  |Print  |  Top

I'm new to chemotherapy coding/billing. Actually, reviewing some old claims.
Appears there are times our MD's bill for an E&M (99212 & 99213), as well as the actual chemo codes.
Theses E&M codes are modified with -25, which then bypass CCI edits.
Upon review of documentation, their E&M levels are accurate but I do find the E&M is related only to the assessment of the patient and plan that relates to the chemotherapy.
I am under the impression that in order to bill an E&M along with chemo codes, the E&M must stand on its own, independent, separate and unrelated of any chemotherapy given that day.
I would greatly appreciate any clarification of this coding.
Deb P



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