1. D

    Infusion admin 96365 / possible reaction

    Looking for assistance with 96365. Infusion started and then stopped at 3minute mark due to patient condition. May we still bill the 96365 with a 52 modifier? Patient was continually monitored for almost an hour before discharge. Any guidance will be appreciated. Thanks, Donna
  2. M

    CPT 96365 and 96367 in Outpatient Hospital Setting

    Hello all. I'm wondering if anyone can help. I'm auditing an outpatient UB that has 96365 on 10/9/18 and 96367 on 10/10/18. I'm new to Outpatient coding and was wondering if billing these on different dates of service is allowed. The itemized bill does not have times or anything like that...
  3. B

    Infusion Therapy Billing

    Hello, I've been away from Infusion billing for a few years now and am about to start billing for an infusion therapy center again. I'm confused on Medicare and Commercial Billing. Medicare billing is daily basis correct? Unless DME provider and bill Pumps, etc. to DMERC. Now say if a...
  4. R

    Cpt 96365

    Cpt 96365? Nobody knows??? Do not report for services provided by physicians or other qualified health care providers in facility settings. What does this mean exactly for CPT 96365? I am so confused Can an CRNP or MD in an outpatient facility bill for 96365?
  5. K

    96413 verses 96365

    Can someone explain the difference between 96413 & 96365? We administer infusions of drugs such as Remicade, Actemra and Orencia. We have always been told to bill 96413 to Medicare and 96365 for all other insurance companies, but we are now having some debate about whether we should be using...
  6. K

    Wiki paracentesis - help!

    Our providers are always coding 96365 with the paracentesis codes in order to capture the albumin infusion. I delete the 96365 code due to CCI edits. Everybody is divided here as to whether I should be doing this. Does anybody know whether I am making a mistake by dropping the infusion code?
  7. T

    Wiki 96365 for "Teach and Train"

    Our office has patients going home with elastomeric devices for IV antibiotic infusions. The patient comes to our office infusion center to pick up their drugs and supplies and to be taught how to administer these themselves at home. When the patient is being taught they are receiving an...