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.