Oncology & Hematology Coding Alert

Reader Questions:

Only Report Irrigation, Not Office Visit

Question: When a patient presents for venous device irrigation, should we only bill 96523, or can we also report 99211 along with a flush tray?

California Subscriber

Answer: You should not bill 99211 (Office or other outpatient visit for the evaluation and management of an established patient -) with 96523 (Irrigation of implanted venous access device for drug delivery systems), because the procedure work includes the office visit components. All items to perform the flush, including the tray, make up the content of 96323, so you should not bill them separately.

Bottom line: Only report 96523 for the encounter and service.

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