apollo06
Networker
- Messages
- 46
- Location
- Suffolk, VA
scenario:
pt admitted (4yo) because of facial drooping and fever, recently diagnosed with AML. Like two days recent. pt was due to start chemo that day. Coded a subsequent E/M for each day pt had chemo and LP and payor is denying chemo, paying E/M and LP. Pt was admitted to hospital for a month. He is on a very high dose of chemo and they are treating his AML aggressively.. my question is this: Since this is a high dosing of chemo, can you code chemo with any E/M at all ever? Providers insist they are assessing pt each time with exam and making the determination if pt is stable for that days treatment. I realize if the pt has a separate issue we can code the E/M with a 25, but the days they are seeing the patient before chemo there isn't anything but chemo. The facial drooping and fever were resolved after two days with meds.
pt admitted (4yo) because of facial drooping and fever, recently diagnosed with AML. Like two days recent. pt was due to start chemo that day. Coded a subsequent E/M for each day pt had chemo and LP and payor is denying chemo, paying E/M and LP. Pt was admitted to hospital for a month. He is on a very high dose of chemo and they are treating his AML aggressively.. my question is this: Since this is a high dosing of chemo, can you code chemo with any E/M at all ever? Providers insist they are assessing pt each time with exam and making the determination if pt is stable for that days treatment. I realize if the pt has a separate issue we can code the E/M with a 25, but the days they are seeing the patient before chemo there isn't anything but chemo. The facial drooping and fever were resolved after two days with meds.