Oncology & Hematology Coding Alert

Question: A patient was suffering from nausea and vomiting, so our provider ordered two intravenous (IV) pushes of Pepcid and Zofran. A nurse started both pushes at the same time using the same IV access site, and both lasted under an hour. Are these pushes regarded as sequential or concurrent, and how would I code them?

AAPC Forum Participant

Answer: CPT^® guidelines define a sequential push as “an infusion or IV push of a new substance or drug following a primary or initial service,” while they define a concurrent push as “an infusion of a new substance or drug infused at the same time as another substance or drug.”

Based on these definitions, what you have described is a concurrent push. Assuming the IV push lasted more than 15 minutes, use 96365 (Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); initial, up to 1 hour) as the initial, or base, code, and +96368 (Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); concurrent infusion (List separately in addition to code for primary procedure)) for the second drug administered.

Per the code descriptors, you also have to specify the substance or drug the nurse administered. For your encounter, report HCPCS Level II codes J2405 (Injection, ondansetron hydrochloride, per 1 mg) for the Zofran and S0028 (Injection, famotidine, 20 mg) for the Pepcid.