Background: Chemotherapy administration services (CPT codes 96400, 96408 to 96425, 96520 and 96530) , therapeutic or diagnostic infusions (excluding chemotherapy) (CPT codes 90780 to 90781), and drug injection codes (90782 to 90788) are paid under the Medicare physician fee schedule.
Can you bill an office visit with chemotherapy?
Office visits on the day of chemo should be reported using the appropriate E/M code (usually 99214-99215) with modifier -24 if during the global period. To indicate the reason for the visit use code Z01.
What is the CPT code for chemotherapy administration via IV push?
+96411—Chemotherapy administration; intravenous, push technique, each additional substance/drug (list separately in addition to code for primary procedure) 96413—Chemotherapy administration, intravenous infusion technique; up to one hour, single or initial substance/drug.
When do you code 96368?
Concurrent infusions (CPT add-on code 96368) are only reported once per day regardless of whether the concurrent infusion lasts for multiple hours or whether additional drugs or substances are administered concurrently. Sequential services can be thought of as services that occur before or after another.
Which codes are for chemotherapy drugs?
Drug administration services are reported with CPT codes in the range 96360-96379 for Hydration, Therapeutic, Prophylactic, and Diagnostic Injections and Infusions, and range 96401-96549 for Chemotherapy and Other Highly Complex Drug or Highly Complex Biologic Agent Administration.
How is chemo billed insurance?
If you’re a hospital outpatient, you’ll be charged a Part B copay. And if you get your chemo in a doctor’s office or clinic, you’ll pay 20 percent of the Medicare-approved amount as well as toward the Part B deductible, if applicable.
How do you bill chemo infusion?
Assign CPT 96360- IV hydration, initial 31-90 minutes, and CPT 96361 (add on code), used once infusion lasts 91 minutes in length. An intravenous infusion of hydration of 30 minutes or less is not billable. Hydration infusion must be at least 31 minutes in length to bill the service.
How do you code IV push?
Code CPT 96374 to report an IV push injection of a single or initial substance/drug.
What is the difference between CPT code 96374 and 96375?
IV push is reported with 96374 for a single or intial drug or substance. … Additional sequential IV push is reported with add-on codes 96375 for a new drug or substance or 96376 for the same drug or substance when provide in a facility.
How do you bill for IV infusion?
CPT code 96360, Intravenous infusion, hydration; initial, 31 minutes to 1 hour, would be reported for this encounter because there was no other intravenous infusion service performed during this encounter and the primary reason for the encounter was to administer the fluids and electrolyte(s) due to fluid loss from the …
What is admin code 96413?
Code 96413 (chemotherapy administration, intravenous infusion technique; up to one hour, single or initial substance/drug) would be used to report the first 90 minutes of the infusion.
Is 96367 an add-on code?
Add-on code 96367, …; additional sequential infusion of a new drug/substance, up to one hour.
How do you code an injection?
Subcutaneous and Intramuscular Injection Non-Chemotherapy
Instead, the administration of the following drugs in their subcutaneous or intramuscular forms should be billed using CPT code 96372, (therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscular).