Urology Coding Alert

If you're not reporting the drug supply, you could be losing more than $200 per treatment If you don't have a handle on drug-therapy coding, such as for Lupron and Eligard injections, you could be leaving money on the table. Key: If your urologist performs these services, you need to report the administration code along with the appropriate supply code, based on how much of the drug the urologist gives the patient. Follow these expert guidelines to be sure you capture every part of these potentially lucrative services.
First Choose an Administration Code The first code choice you need to make for injection services is the administration code. The appropriate code depends on the drug therapy type your urologist provides. Choose from the following codes:  90765 -- Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); initial, up to one hour -- Use for Zometa. +90766 -- ... each additional hour (list separately in addition to code for primary procedure) -- Use for any drug your urologist gives after a second infusion, up to eight hours. +90767 --... additional sequential infusion, up to 1 hour (list separately in addition to code for primary procedure) -- Use for any drug the urologist gives after an initial infusion. This is an add-on code to 90765 and 90774 (see below), so you should not use it alone. +90768 --... concurrent infusion (list separately in addition to code for primary procedure) -- Use for any drug the patient receives at the same time as an initial infusion. This is an add-on code to 90765 and 90766, so you should not use it alone.  90772 -- Therapeutic, prophylactic or diagnostic injection (specify substance or drug); subcutaneous or intramuscular -- Use for testosterone injections, antibiotic injections and for other drugs such as B12 or Epogen.  90774 -- ... intravenous push, single or initial substance/drug -- Use this code for intravenous gentamycin injections your urologist gives. +90775 -- ... each additional sequential intravenous push of a new substance/drug (list separately in addition to code for primary procedure) -- Use for any additional drugs your urologist administers intravenously during the same session as above. This is an add-on code to 90765 and 90774, so you should not use it alone.  96402 -- Chemotherapy administration, subcutaneous or intramuscular; hormonal anti-neoplastic -- Use this code for Lupron, Zoladex and Trelstar injections. Code Separate E/M Service With Modifier 25 Bonus: If the urologist performs a separately identifiable service at the same time as the injection, such as an office visit, you can report that service separately using modifier 25 (Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other [...]