Oncology & Hematology Coding Alert

Question: The patient presents for chemotherapy (57-minute infusion). Staff mixed three non-chemo drugs in a single bag and administered them during a 45-minute infusion prior to chemotherapy. How should I code this? I'm confused about whether I should report concurrent infusion code +96368.

California Subscriber

Answer: Your "initial" code for this case should be 96413 (Chemotherapy administration, intravenous infusion technique; up to 1 hour, single or initial substance/drug). This code describes up to an hour of chemotherapy infusion.

For the three drugs mixed in a single bag and infused subsequent to 96413, you should report a single unit of +96367 (Intravenous infusion, for therapy, prophylaxis, or diagnosis [specify substance or drug]; additional sequential infusion of a new drug/ substance up to 1 hour [List separately in addition to code for primary procedure]).

You should not report the concurrent infusion code for this case. The concurrent infusion code is appropriate for multiple bags infused simultaneously. The code is not appropriate for reporting administration of multiple drugs in a single bag, states CPT® Assistant (November 2006). This instruction still applies although, after the article was published, the code was renumbered from +90768 to be +96368 (Intravenous infusion, for therapy, prophylaxis, or diagnosis [specify substance or drug]; concurrent infusion [List separately in addition to code for primary procedure]).