Wiki ov during global to discuss chemotherapy

[BFortson]

Needs some help coding an office vist that occurs during the 90 day global to discuss chemotherapy. We have a GYN surgical oncologists that has his patients return in the post op to discuss their options for chemotherapy. He spends a great deal of time with the patient. Can this be billed and if so what codes?

 

[OCD_coder]

This really depends on the carrier preferences.

WPS states that chemotherapy treatment is not typical or considered part of recovery from surgery, it is the underlying treatment plan. So it could be billable with a modifier 24 on the E&M service. Be aware the diagnosis may not be the actual cancer, but a V-code depending on what information is documented.
WPS~
Physicians who are managing chemotherapy during the post-operative period of a procedure may bill for the E/M service with modifier 24. ICD-9-CM V58.1 may be appropriate to document the need for this service.


Novitas states that a different diagnosis is required for E&M services performed within a global.

Sources:
CMS Global Surgical Fact Sheet
http://wpsmedicare.com/j5macpartb/resources/modifiers/globalsurgmodifiers.shtml

 

[syllingk]

cms says that an e/m after surgery to talk about the underlying disease is payable.