kathleeng
Guru
For patient's that are on a 7-day cycle using a portable pump, I know we bill the 96416 on the day of initiation and 96521 for when the patient comes into the office for a refill. However, does the same code of 96521 apply when the patient comes in, the pump is fully disconnected and a new pump is started during the same cycle?
The guidelines say:
"Certain chemotherapy regimens require that a chemotherapy drug be infused for a period of 8 hours or longer. In these regimens, it is common for the drug(s) to be administered through a portable or implantable pump and for the patient to leave the office after the pump is set up. Sometimes, the prolonged infusion requires the patient to return to the office or facility the next day to have the pump refilled so the infusion can continue..... For example: 96416 is reported on the day the pump is set up and initiated for the patient, and 96521 is reported for each subsequent day the pump needs to be refilled. When the treatment cycle or regimen begins again, code 96416 is reported for the initiation of the pump." https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2900877/
The guidelines say:
"Certain chemotherapy regimens require that a chemotherapy drug be infused for a period of 8 hours or longer. In these regimens, it is common for the drug(s) to be administered through a portable or implantable pump and for the patient to leave the office after the pump is set up. Sometimes, the prolonged infusion requires the patient to return to the office or facility the next day to have the pump refilled so the infusion can continue..... For example: 96416 is reported on the day the pump is set up and initiated for the patient, and 96521 is reported for each subsequent day the pump needs to be refilled. When the treatment cycle or regimen begins again, code 96416 is reported for the initiation of the pump." https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2900877/