Wiki Immunosuppressive therapy service

[dzarick1]

For auditing purposes what should be documented to support the billing for this service by the transplant provider within the global surgical period? I cannot locate an LCD or NCD and CMS specifically states this is a billable service however I am concerned about the specfic documentation requirements.

 

[CC5657]

Here is a web site that you might find your answer. Scroll down to #120, 120.1

Hope this helps!

http://www.cms.gov/manuals/downloads/clm104c08.pdf

 

[Pupapu]

See page 40 on CMS
Medicare Claims Processing Manual
Chapter 12 - Physicians/Nonphysician Practitioners

30.6.3 - Payment for Immunosuppressive Therapy Management

(Rev. 1, 10-01-03)

B3-4820-4824

Physicians bill for management of immunosuppressive therapy using the office or subsequent hospital visit codes that describe the services furnished. If the physician who is managing the immunotherapy is also the transplant surgeon, he or she bills these visits with modifier “-24” indicating that the visit during the global period is not related to the original procedure if the physician also performed the transplant surgery and submits documentation that shows that the visit is for immunosuppressive therapy.