Wiki Chemotherapy Drug Consults

[Mwischhusen]

Our oncologists want to report consult codes (99446-99449) when they are compiling a treatment plan for chemotherapy for a patient. This is then sent to an oncology pharmacist who weighs in on if they think the course of treatment is appropriate. Is this the correct way to be reporting this service? It seems as though the pharmacist should be reporting the consult code, but the provider is wanting to report a CPT to capture the workload of reviewing the chart and collaboration. Any advice greatly appreciated.

 

[sls314]

Our oncologists want to report consult codes (99446-99449) when they are compiling a treatment plan for chemotherapy for a patient. This is then sent to an oncology pharmacist who weighs in on if they think the course of treatment is appropriate. Is this the correct way to be reporting this service? It seems as though the pharmacist should be reporting the consult code, but the provider is wanting to report a CPT to capture the workload of reviewing the chart and collaboration. Any advice greatly appreciated.

Those codes can only be billed by the consultative provider, not the treating/requesting provider. It looks like 99452 could be billed by the treating physician in a consultation, if the time exceeds the threshold.

I work for oncologists, but we don't bill that charge to my knowledge. (I primarily work with rad onc, not med onc, so it's possible that we're billing something for that time & I just don't know about it.)

 

[rachaelwilleford]

Providers have long been trying to capture their time and workload, especially in these situations. If it's the day of a visit, they can bill for prolonged services. Unfortunately chart review is part of the job and yes some are more complicated than others. Billing this code is not the way to go about capturing this though.

 

[Mwischhusen]

Providers have long been trying to capture their time and workload, especially in these situations. If it's the day of a visit, they can bill for prolonged services. Unfortunately chart review is part of the job and yes some are more complicated than others. Billing this code is not the way to go about capturing this though.

I complete agree. In my opinion there is not a CPT that describes this at all. Appears to me it’s a plain and simple chart review and chemotherapy treatment plans are just a standard of care. Thanks for your input. Would you happen to know any resources that can reinforce this position to provide to my providers?

 

[rachaelwilleford]

I complete agree. In my opinion there is not a CPT that describes this at all. Appears to me it’s a plain and simple chart review and chemotherapy treatment plans are just a standard of care. Thanks for your input. Would you happen to know any resources that can reinforce this position to provide to my providers?

CPT book states that E/M visits include total time spent by the provider on the date of service including face to face and non-face-to-face activities which may include documenting clinical information in the electronic or other health record.