Forum - Questions & Answers
Hospital Base Oncology Infusion & E/M Visit
I'm hoping someone can help me with the correct process for submitting an E/M service performed the same DOS as IV Infusion Therapry done in a hospital base clinic. I will be meeting with our Hematology/Oncology physicians and would like to give them accurate and compliant information.
Scenario:
An oncology patient receives IV infusion therapy at a hospital base clinic and our Hematology/Oncology physician also sees the patient and does a separately identifiable E/M service. Should that E/M visit be reported with a modifier 25? When the infusion services are done in our private office and an E/M service is separate from the infusion visit we add the modifier 25. I'm getting conflicting info on whether adding the modifier 25 to the E/M visit done by our physician in the hospital base clinic. The NP's & RNs at the hospital clinic are employeed by the hospital and the hospital will bill for the drug & administration services.
Thanks in advance for any clarification
Jane
re: Hospital Base Oncology Infusion & E/M Visit
If the only service on your claim is an E/M service, you should not need a modifier.
re: Hospital Base Oncology Infusion & E/M Visit
Yes, you can add the mod25.