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Chemo teaching

  1. Default Chemo teaching
    Medical Coding Books
    We were told that we can't bill for chemo teaching even if it is on a separate day from the actually chemo. For example, patient needs chemo, comes in on Monday and gets the education by an RN in an hospital based outpatient clinic and then begins treatment on Wednesday. Can we bill a 99211 for the Monday visit?

  2. #2
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    Nashville AAPC Chapter
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    We are billing for the chemo teaching. We use the V65.49 as a second Dx for our tracking purposes.

    We have a NP do our chemo-teaching and we are using the ASOG manual that states we can bill for chemo-teaching post-operatively. We don't know what the treatment will be until we know if the patient has cancer.
    Last edited by OCD_coder; 02-14-2011 at 12:06 PM.

  3. #3
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    Columbia, MO
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    Quote Originally Posted by traci.susong@gmail.com View Post
    We were told that we can't bill for chemo teaching even if it is on a separate day from the actually chemo. For example, patient needs chemo, comes in on Monday and gets the education by an RN in an hospital based outpatient clinic and then begins treatment on Wednesday. Can we bill a 99211 for the Monday visit?
    Are you billing for the physician office or the outpatient clinic? Is this nurse the hospital employee working in your hospital based clinic? It all makes a big difference.
    *Physician office POS 11 and your nurse goes to the facility to do chemo teaching, you cannot charge for this at all.
    *physician clinic hospital owned POS 22, the nurse does chemo teaching in the clinic setting, this cannot be billed by the physician office, but can be billed by the facility.
    * physician office POS 11, nurse is doing chemo teaching in the office setting while a provider is on site this can be billed, either 99211 or possibly 98960.

    Debra A. Mitchell, MSPH, CPC-H

  4. Default chemo teaching
    This is an outpatient hospital clinic. The RN is employed by the hospital. So I was viewing it has an "internal resource" being used.

  5. #5
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    Columbia, MO
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    Yes the facility can bill for this either you have "points" on your tool to assign this as a visit level for a 510 revenue center, or some other way to account for this that corresponds to a visit level.

    Debra A. Mitchell, MSPH, CPC-H

  6. Default Chemo teaching
    the acuity form we have does not have a "spot" or any points allocated to teaching. so if the RN spends "more time" than her visit level would probably be higher than a 99211, correct? The RNs spend an average of 30-60 minutes on chemo teaching.

  7. #7
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    Columbia, MO
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    Ok what you need is to create a "spot" for chemo teaching, you cannot assign a visit level based on time. You can do something such as:
    chemo teaching basic = 99211
    chemo teaching moderate = 99212
    chemo teaching advanced = 99213
    and have criteria as to what each level consists of. I know our chemo nurses had different levels based on the patients expected course of treatment and diagnosis.
    So you will need to have an addition made to the acuity sheet you currently have before you can begin charging for it.
    Last edited by mitchellde; 02-14-2011 at 09:44 AM.

    Debra A. Mitchell, MSPH, CPC-H

  8. #8
    Location
    Columbia, MO
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    Ok what you need is to create a "spot" for chemo teaching, you cannot assign a visit level based on time. You can do something such as:
    chemo teaching basic = 99211
    chemo teaching moderate = 99212
    chemo teaching advanced = 99213
    and have criteria as to what each level consists of. I know our chemo nurses had different levels based on the patients expected course of treatment and diagnosis.
    So you will need to have an addition made to the acuity sheet you currently have before you can begin charging for it.

    Debra A. Mitchell, MSPH, CPC-H

  9. Default chemo teaching
    Thanks. Do you have a sample. I think our other problem is that we just purchased software to assist with assigning appropriate E/M levels and their people are sying no because it's included in the chemo admin code. We use Lynx now. I will need some concrete items to present to my boss and then I am sure he will run it past compliance.
    If you have sample, you can sand to my email address which is my user name. Thanks so much!!!

  10. Default
    Quote Originally Posted by mitchellde View Post
    Ok what you need is to create a "spot" for chemo teaching, you cannot assign a visit level based on time. You can do something such as:
    chemo teaching basic = 99211
    chemo teaching moderate = 99212
    chemo teaching advanced = 99213
    and have criteria as to what each level consists of. I know our chemo nurses had different levels based on the patients expected course of treatment and diagnosis.
    So you will need to have an addition made to the acuity sheet you currently have before you can begin charging for it.
    Do you have a sample of what your nurses used?

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