tci Part B Insider - 2003 Issue 18

Can You Bill 99211 With Chemotherapy?

Documentation Is the KeyIf a patient comes in for routine chemotherapy and doesn't see the doctor, can you still bill 99211 for incident-to services provided by a nurse or nonphysician practitioner? Many consultants say no, unless the nurse or NPP does more work than simply making sure the patient is fit for chemo and preparing him or her. "My answer is no, you don't get the E/M separately," says Mike Misko, certified coder with Cavanaugh Michaels in Mechanicsburg, Pa. He says you'd have to justify using modifier -25 (Significant, separately identifiable E/M service by the same physician...

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