sorcha48
Networker
- Messages
- 71
- Location
- Gladwin, MI
I have been having an issue with billing monoclonal antibody treatment. It has dragged out for months.
I have asserted that the CPT and CMS state monoclonal antibodies are billed as 96365. However, I have received push back on this. I got an email that stated that Cextuimab billing should be handled like this:
"The patient was being treated for cancer of the head and neck. For Head and Neck cancer, when the drug is used with radiotherapy, the provider would use the 96365 CPT code as it was not part of chemotherapy.
Either CPT code 96413 or 96365 could work for this drug administration depending on the situation the drug was administered."
I need somone who handles monoclonal antibody to help me out with this.
I have asserted that the CPT and CMS state monoclonal antibodies are billed as 96365. However, I have received push back on this. I got an email that stated that Cextuimab billing should be handled like this:
"The patient was being treated for cancer of the head and neck. For Head and Neck cancer, when the drug is used with radiotherapy, the provider would use the 96365 CPT code as it was not part of chemotherapy.
Either CPT code 96413 or 96365 could work for this drug administration depending on the situation the drug was administered."
I need somone who handles monoclonal antibody to help me out with this.