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Gastroenterology Coding Alert

READER QUESTIONS:

Watch for 'Add-Ons' During Remicade Sessions

Published on Tue Oct 27, 2009

Question: An established patient with a plan of care in place for his Crohn's disease of the ileum reports to the gastroenterologist for a Remicade infusion. The infusion started at 10:00 a.m. and ended at 11:42. The patient reported nausea during the infusion, so the gastroenterologist administered 200 mg of Benadryl from 10:41 to 10:52. How should I report this encounter? North Carolina Subscriber Answer: This claim has a lot of moving parts; you can code for both the Remicade and the Benadryl administrations. Because your Benadryl infusion time was so short, however, you should not report an infusion code for that service. Follow this two-step guidance on how to ethically maximize this claim: Step 1 -- Remicade: The total infusion time for the Remicade treatment was an hour and 42 minutes. Represent this time with the following: • 96413 (Chemotherapy administration, intravenous infusion technique; up to 1 hour, single or [...]
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