Oncology & Hematology Coding Alert

Question: How should I code for pre-admin services for IVIG?

Washington, D.C., Subscriber

Answer: You need to report the pre-admin service on the same claim with the same date of service as the IVIG and the drug admin service.
 
What to do: Report the pre-admin service with G0332 (Services for intravenous infusion of immunoglobulin prior to administration [this service to be billed in conjunction with administration of immunoglobulin]). Only report one pre-admin service per day per patient.

Report the IVIG with J1566 (Injection, immune globulin, intravenous, lyophilized [e.g., powder], 500 mg) or J1567 (Injection, immune globulin, intravenous, non-lyophilized [e.g., liquid], 500 mg). And remember to use the correct units.

Report the drug admin with a code such as 90765 (Intravenous infusion, for therapy, prophylaxis, or diagnosis [specify substance or drug]; initial, up to 1 hour) or +90766 (- each additional hour).

CMS pays this extra pre-admin service to cover your practice's effort in acquiring adequate IVIG product and to prepare for the infusion. The billing requirements remain the same as in 2006.

Read more in MLN Matters article MM5428, -Medicare Payment for Preadministration-Related Services Associated with IVIG Administration -- Payment Extended through CY 2007- at www.cms.hhs.gov/MLNMattersArticles/downloads/MM5428.pdf.