Gabi Posted Mon 13th of August, 2018 13:28:21 PM
Can you advise if an oncology practice office can bill a chemo drug, ambulatory infusion pump and initiation of the drug/pump on the same day as discharge from hospital. Can the provider bill for both the discharge with modifier 25 and the initiation code, should we use a modifier 59 with the initiation?
SuperCoder Answered Tue 14th of August, 2018 08:14:54 AM
Yes, the provider can report both discharge date and office visit procedure on the same day. As per NCCI edits, there is bundling conflict between discharge day code and chemo therapy drug administration code. You are advised to report chemo therapeutic drug administration code with modifier 59. You need not to add any modifier with discharge day code.
Note: Do not report any additional E&M code for office visit with chemotherapy drug administration as this part of service would be considered inclusive with chemo drug infusion services.