Oncology & Hematology Coding Alert

Question: What chemo administration code should I use for the date that we start treatment with a portable infusion pump?

Texas Subscriber 
 
Answer: You should report the initial dose with 96416 (Chemotherapy administration, intravenous infusion technique; initiation of prolonged chemotherapy infusion [more than 8 hours], requiring use of a portable or implantable pump).
      
Code 96416 is new for 2006. CPT deleted old code 96414 (... infusion technique, initiation of prolonged infusion [more than 8 hours], requiring the use of a portable or implantable pump), renumbered it to be 96416, and revised the descriptor. A note with 96416 tells you to see 96521-96523 for refilling and maintenance of a portable pump or an implantable infusion pump.
     
Remember: Append modifier KD (Drug or biological infused through DME) to the HCPCS drug code to indicate administration through a DME infusion pump. 
 
CMS pays DME-administered drugs at a higher rate than those infused another way (such as injection).