Oncology & Hematology Coding Alert

Added instruction stresses need for separate services

You probably know that you should append modifier 25 to a visit only when the oncologist's documentation supports a significant and separate service. CPT 2006, however, will reinforce this guideline.

The update will clarify modifier 25's (Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service) explanatory text. The new explanation will state that a -significant, separately identifiable E/M service- should have documentation that meets the requirements for the E/M service being reported.
 
This solidifies most coding experts- recommendations that you should be able to lift the E/M documentation from your notes and it should stand as a completely separate service from what the oncologist performed during the procedure or service.