AAPC - Back to school
Results 1 to 2 of 2

Thread: Clinical Trials

  1. #1

    Default Clinical Trials

    AAPC: Back to School
    I would like clarification on how to appropriately report routine cost associated with clinical trial services using modifier Q1 and secondary diagnosis code V70.7. Should practices report the modifier and diagnosis code to each line item associated with the clinical trial? Also, since the drug is usually supplied by the pharmaceutical company at no cost to the practice we would bill for the administration of the drug. Should we report a J code with a $0 charge and is there a reduction in reimbursement when the Q1 modifier is attached to routine services?

    Below is an example of a claim in question:


    172.8, V70.7


    172.8. V70.7


    172.8, V70.7


    172.8, V70.7


    172.8, V70.7


    172.8, V70.7


    Would the above example be the correct way to report routine cost associated with a clinical trial?

  2. #2

    Default clinical trial response

    placing the Q1 modifier doesn't reduce re-imbursement. As far as placing the modifier with the V70.7 code on each line item, this has been an uncleared question and response from CMS. As a member of the POE chapter of medicare, I have requested a webcast on billing clinical trials. My understanding since the year 2000 and 2007, the modifier with the V70.7 was placed on the administration charge only that is identified as routine cost. the modifier Q0 with the V70.7 is placed on the services that are identified as non-routine cost not affiliated with routine chemotherapy regimens, such U/A. I believe we are probably reading the same CMS guidelines which are confusing to a "coder's language". Looking forward to additional input.

Similar Threads

  1. Clinical trials billing - HELP PLEASE!!
    By rachelb@leadingcancercare.com in forum Hematology/Oncology
    Replies: 0
    Last Post: 01-17-2014, 08:50 AM
  2. Oncology Clinical Drug Trials
    By stwhitedeer in forum Hematology/Oncology
    Replies: 2
    Last Post: 08-19-2011, 07:50 AM
  3. Clarification with Clinical Trials Coding-V70.7
    By ecastillo in forum Medicare Regulations
    Replies: 0
    Last Post: 09-29-2010, 08:09 AM
  4. Tens Unit Trials
    By heatherwinters in forum Orthopaedics
    Replies: 0
    Last Post: 05-13-2008, 08:41 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts

Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.