lillianivy
Networker
- Messages
- 59
- Location
- Livingston, LA
Scenario:
Avastin given IV 30min in mediport
5FU given IVP 3min in mediport
5FU given CIV in Pump
We were billing:
96413 x 1 - Avastin
96411 x 1 - 5FU
96416 x 1 - 5FU in pump
This is what I was taught in school and I remember a question on the exam for this.
Humana is now telling us that since 96411 states in the CPT book "each additional substance/drug" and since 5FU is the same drug given in both the pump and mediport, we can not bill for the administration in the mediport because it is the same drug. In the CPT Chemo guidelines it states "Report separate codes for each parenteral method of administered by different techniques." Humana is not buying it.
Please help!!!
Avastin given IV 30min in mediport
5FU given IVP 3min in mediport
5FU given CIV in Pump
We were billing:
96413 x 1 - Avastin
96411 x 1 - 5FU
96416 x 1 - 5FU in pump
This is what I was taught in school and I remember a question on the exam for this.
Humana is now telling us that since 96411 states in the CPT book "each additional substance/drug" and since 5FU is the same drug given in both the pump and mediport, we can not bill for the administration in the mediport because it is the same drug. In the CPT Chemo guidelines it states "Report separate codes for each parenteral method of administered by different techniques." Humana is not buying it.
Please help!!!