Oncology & Hematology Coding Alert

Protect Yourself:

CMS Zeroes In on Infusions Over 8 Hours

Keep in mind these 2007 changes for drug admin If you can't remember which codes you can match with the concurrent infusion code, a new instruction guides you to the correct answer. Here are the drug admin CPT changes you need to know.

- CPT 2007 removes -up to 8 hours- from both +90761 (Intravenous infusion, hydration; each additional hour [list separately in addition to code for primary procedure]) and +90766 (Intravenous infusion for therapy, prophylaxis, or diagnosis [specify substance or drug]; each additional hour [list separately in addition to code for primary procedure]).

- CPT 2007 removes -1 to 8 hours- from +96415 (Chemotherapy administration, intravenous infusion technique; each additional hour [list separately in addition to code for primary procedure]) and +96423 (Chemotherapy administration, intra-arterial; infusion technique, each additional hour [list separately in addition to code for primary procedure])

Red flag: Expect CMS to monitor physician offices that exceed eight hours of infusion. The primary reason CPT removed the eight-hour limit in these code descriptors is that hospitals use the codes now, as well.

- CPT 2007 adds the instruction that you may report +90768 (Intravenous infusion, for therapy, prophylaxis, or diagnosis [specify substance or drug]; concurrent infusion [list separately in addition to code for primary procedure]) with IV infusion codes 90765 and 90766 and chemo admin codes 96413, 96415, 96416, 96422 and 96423.
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