96368(concurrent Infusion) confusion

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When premeds for chemotherapy are administered in separate bags but concurrently should they be coded 96367x2 or 96367 and 96368? EPIC suggested charges are giving me a run for my $ with this code. Can any examples be provided that were created by CMS or AAPC? Thank you in advance.
 

trarut

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I would report 96367 for bag 1 and 96368 for the bag 2 being run concurrently, assuming the administration time of each bag meets the requirements to report an infusion.
 
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Kelso, WA
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I would report 96367 for bag 1 and 96368 for the bag 2 being run concurrently, assuming the administration time of each bag meets the requirements to report an infusion.
I have been charging that but recently looked into the 96368 code and it states to be used in conjunction with 96413, 96415, 96365 and 96366. What do you think? I was reviewing another charge capture specialist in our network and they are charging 96367 x 2 rather than the concurrent.
 

trarut

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Since 96368 is an add-on code, it requires a primary or initial administration code so I interpret that instruction as being the primary admin codes that are required on the claim for 96368 to be billable, excluding add-on codes 96415 & 96366 for add'l hours. Concurrent infusions are defined as "an infusion that occurs at the same time as another infusion" (all credit to AAPC Coder for the definition :))...not at the same time as a primary or initial infusion so using 96368 for the other drug is not incorrect in my opinion.

There is an Oncology & Hematology Coding Alert case study from May 2009 that supports the use of 96368 in an example with Dex & Phenergan in two bags, run concurrently, reported with 96367x1 and 96368.

At my last job, most of our concurrent infusions were 5FU/Leucovorin but we occasionally had premeds run concurrently over the years and this is how we reported them.

ETA - Fixed typo to correct 96367 to 96368.
 
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