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Oncology Office Visit then Chemo - mod 25?

  1. #1
    Question Oncology Office Visit then Chemo - mod 25?
    Medical Coding Books
    Need help with modifier 25. Here is the scenario:

    Patient see's the Oncologist to talk about whether its ok to have Chemo that same day. The Oncologist says yes and the patient is sent over to the Chemo Infusion Room.

    Question: Would the clinician attach modifier 25 to the LOS (i.e. 99214) for the office visit?


  2. Default
    First you should determine why it was necessary for the patient to see the oncologist prior to having the chemo.

    If it was medically necessary, then yes, a modifier 25 would be appropriate. Not sure if a 99214 would be necessary.

    I'd get the documentation and verify what happened during the visit with the doctor before allowing the E/M and chemo to go out on the same day. JMHO.


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