Bundled E&M when billing under a Incident to doctor that is a Radiation Oncologist

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Bundled E&M when billing under a Incident to doctor that is a Radiation Oncologist

Hello,

I have a handful of sites that I work with that are complaining that they have had the radiation oncologist cover a chemo clinic for the day, see a patient for evaluation because the Medical oncologist was not in the office. They are getting denials for the service as being part of the global radiation period. The advice was to bill with a 24 and 25 modifier for these services and to make sure that the chief complaint for the office was properly coded.

They are often just billing all services under the primary cancer dx code. I am not sure why the radiation oncologist would that is I2 for the purpose of chemotherapy supervision would need to specifically see the patient when the Medical Oncologist is out of the office unless there was a chief complaint outside of the primary cancer dx that would required him to do so. Any guidance on this would be appreciated.
 

thomas7331

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Not sure I completely understand your question, but I think you mean 'incidental to', not 'incident to' is that correct? If so, I agree with you, they probably shouldn't be billing E&M if they are just supervising the chemotherapy administration unless the patient presents with a separate problem that requires treatment on that specific visit.
 
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