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Ordering or Supervising: Whose name goes on chemo claim?

Loni Posted Wed 21st of January, 2015 12:38:46 PM

When the ordering physician is not present for chemotherapy administration, but was the author of the plan of care, does his name or the name of the supervising physician who was present during the time of service go on the claim form? We are a provider in Louisiana and Novitas' LCD A52018 didn't specify.

These two items seem contradictory to me from the Medicare Claims Processing Manual Chapter 26 - Completing and Processing
Form CMS-1500:

Item 17 - Enter the name of the referring or ordering physician if the service or item was ordered or referred by a physician...Similarly, if Medicare policy requires you to report a supervising physician, enter this information in item 17.

***COMPARED TO***

Item 24J - Enter the rendering provider’s NPI number in the lower unshaded portion..."WHEN THE PERSON WHO ORDERED THE SERVICE IS NOT SUPERVISING, ENTER THE NPI OF THE SUPERVISOR IN THE LOWER UNSHADED PORTION"

Which is correct??

SuperCoder Answered Fri 23rd of January, 2015 00:08:50 AM

We are researching and will get back to you ASAP. Thanks !!

SuperCoder Answered Fri 23rd of January, 2015 00:08:50 AM
Researching.
SuperCoder Answered Wed 28th of January, 2015 07:43:37 AM

You should mention the name and NPI of ordering physician in box 17 and mention the NPI of rendering or supervising provider in 24 J lower unshaded portion.

Plus enter the details of billing provider in box 33.

Thanks !!

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