Chemo Observation

[krssy70]

Does anybody bill for the observation time during a chemotherapy encounter. We have patients that are on a study and per protocol, states pt needs to be observed for 4hours after receiving the drug. vitals are documented multiple times throughout this time, and Nursing staff continues to monitor the patient and document findings.

I am hoping to be able to find a way to be able to be reimbursed for this time.

thank you
Kristen

 

[mitchellde]

The observation is a natural part of the chemo administration you cannot charge separately for it even though it takes place after administration or infusion.

 

[krssy70]

thank you for your reply. I just dont understand why you cant bill for time spent after chemo administration. Some of our patients are on a oral chemo study drug and have to be observed for a significant amout of time after they take this pill. Its crazy that we cant bill for that time...

 

[mitchellde]

what code are you currently using for the admin?

 

[krssy70]

We do not bill a admin code, thats why we were hoping we could bill a observation code

 

[mitchellde]

Is there any physician involvement? If this is only nursing activity for an oral medication, the only code that comes to mind is the 99211 and the provider must be in the office at the time of the encounter. There is no other code for nursing observation. If the provider sees the patient there is potential for an office level higher than the 99211 however the time will stop when the provider leaves the room, again there is no way to charge for nursing personnel to observe and take vitals.