If you are seeing the patient as a new patient, then it is more likely that there was a separately identifiable E/M service, but if the patient is new or established and documentation supports a significantly separate E/M service, it can be billed with a 25 modifier. The E/M must be warranted in the medical record.
If the patient is coming in just for the chemo, then the nurse visit 99211 would not be billed in addition to the chemo.
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