Wiki ??? about F/U visits after completion of treatment

[jjkjones@yahoo.com]

I am not really new to the whole Rad/Onc billing and coding but there has recently been the question of whether we can or can't bill out visits within 3 months of completion of the treatment. I am just wondering what others are doing. If you are billing them out, are you getting paid for them? And if you CAN'T bill them, then where is that documentation found? Please help!!! Any info would be appreciated.

 

[jflynn124]

See the bottom of page 25 & the top of page 26.


https://www.cms.gov/Regulations-and..."num":158,"gen":0},{"name":"XYZ"},0,494,null]

 

[astuart@pmsia.com]

I agree with jflynn that all e/m codes are bundled into the treatment management codes.

On rare occasion, you can bill for an office visit during the 90 global period IF the patient is being seen for a new and completely unrelated issue. In those cases, you can add a -24 modifier to the office visit to bypass the global period. (just remember that most insurance companies will require documentation when you use this modifier). Example: a patient is treated for lung cancer and after completion, is discovered to have brain mets that requires a completely new workup. It is not, however, allowed if the physician knew about the brain mets before and just didn't choose to address it yet.

On another note, the e/m codes are only bundled in the treatment management codes. Brachytherapy does not have treatment management codes therefore they don't follow the 90 day rule.