Neurology & Pain Management Coding Alert

  Question: I was told by our Avonex representative that I should be billing the chemo administration code 96401 along with Q3025. Are these the correct codes for administrating Avonex? Nebraska Subscriber Answer: Avonex is an interferon, a biological response modifier, used to treat patients with relapsing forms of multiple sclerosis.  You are correct to use 96401 (Chemotherapy administration, subcutaneous or intramuscular; non-hormonal anti-neoplastic) even though Avonex is not a chemotherapy drug. Due to the complexity of biological response modifier administration, injecting Avonex intramuscularly involves similar complexity and resources as chemotherapy administration. The CPT section guidelines for Chemotherapy Administration state “codes 96401-96549 apply to parenteral administration of non-radionuclide anti-neoplastic drugs; and also to anti-neoplastic agents provided for treatment of noncancer diagnoses or to substances such as certain monoclonal antibody agents, and other biologic response modifiers.” Don’t miss this: Under Medicare guidelines, your neurologist must administer the Avonex personally or incident [...]