CPT^® 96406, Under Injection and Intravenous Infusion Chemotherapy and Other Highly Complex Drug or Highly Complex Biologic Agent Administration

The Current Procedural Terminology (CPT^®) code 96406 as maintained by American Medical Association, is a medical procedural code under the range - Injection and Intravenous Infusion Chemotherapy and Other Highly Complex Drug or Highly Complex Biologic Agent Administration.

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Summary

In this procedure, the provider administers chemotherapy directly into a lesion or tumor. Use this code when the provider treats more than 7 lesions.

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J9040 bleomycin, billing partial

Yes, always round units UP to the nearest unit. Pay attention to mg vs. ccs vs. units. It can get confusing. The 96405 code is usually used for antineoplatic injections for malignant lesion treatmen... [ Read More ]

Intralesional Chemo Injection or Destruction Code

I would code this as 96405. Codes in the 17XXX series are not intralesional and involve destruction of a lesion by the external application of electric current, extreme cold, or chemicals to the l... [ Read More ]

Keloid Excision and Injection with Kenalog 11900 injection keloid wart

The NCCI policy manual says, "It is a misuse of CPT codes 11900, 11901, 96405, or 96406 to report injection of local anesthetic prior to another procedure on the lesion(s). Some of the procedures with... [ Read More ]

17110 and 96405 on one lesion

I don't think the code limits too malignant diagnosis. The cpt says "non cancer diagnosis" but I still use the same code for malignant lesions.. (to be honest the CPT description is confusing to me) ... [ Read More ]

E/M & injection or malignant destruction?

[QUOTE="OCD_coder, post: 296245, member: 16463"]My CPT book by the AMA does not state "non-malignancy" in the description so I am not sure where the failure is for us. Yes, you can use the code. Her... [ Read More ]

E/M & injection or malignant destruction?

My CPT book by the AMA does not state "non-malignancy" in the description so I am not sure where the failure is for us. Yes, you can use the code. Here is the lay description for the 96405: The phys... [ Read More ]

E/M & injection or malignant destruction?

[QUOTE="OCD_coder, post: 294411, member: 16463"]CMS and a few MAC's have written guidelines that New patient visits are exempt from the Mod-25 rules (Palmetto). Thier rationale is that an E&M is appr... [ Read More ]

E/M and injection

CMS and a few MAC's have written guidelines that New patient visits are exempt from the Mod-25 rules (Palmetto). Thier rationale is that an E&M is appropriate obtain new history and to determine the ... [ Read More ]

E/M & injection or malignant destruction?

Modifier 25

I also found this if this will help you. Happy coding! :) Procedures such as biopsies (CPT codes 11100, 11101), shave removals (CPT codes 11300 through 11313), intralesional injections (CPT codes 119... [ Read More ]

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