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Oncology & Hematology Coding Alert

Reader Question:

Submit 90784 Claims Separately From E/M Services

Published on Tue Aug 26, 2003

Question: How can we properly bill for 90784 when our oncologist performs a therapeutic injection? Can we report 90784 on the same day as other codes? Also, what are other bundling and denial issues?

New Jersey Subscriber Answer: You cannot submit a claim for 90784 (Therapeutic, prophylactic or diagnostic injection [specify material injected]; intravenous) on the same day as an E/M service, such as 99213 (Office or other outpatient visit ... established patient) because Medicare carriers, such as First Coast Service Options in Jacksonville, Fla., view 90784 as incidental to the E/M service. You may separately report the drug used with the appropriate HCPCS code, such as J0697 (Injection, sterile cefuroxime sodium).
 
Remember that 90784, as well as therapeutic injection code 90782 (... subcutaneous or intramuscular), covers each injection but not the drug administered. For example, if your physician administers both Demerol (J2175) and Phenergan (Q0170), during the treatment of breast cancer (174.x), you should list only one injection code, such as 90784.
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