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Hello, I am wondering if I can get a few opinions on how these two cases would be billed. I'm not including dosages and pre-meds. I'm really only concerned about two drugs and what administrations are billable. I was instructed to bill 96413, 96415, 96368, 96411 for both cases.

First case:
Ifex mixed with Mesna: 13:08-16:06
Mesna: 13:08-13:53
Mesna: 12:12-12:20

Second case:
Ifex mixed with Mesna: 13:08-16:06
Mesna: 13:08-13:53

Thanks for your help.
 
My thoughts

I have only been in my position for 6 months and we do not have either of those drugs but my thought is that you would code 96413, 96415 x 2, 96411. I thought there was a rule about coding the same drug twice within a certain timeframe, that is why I would skip the 96368, even though it does run at the same time.

The second option I would just code the 96413 96415 x 2.

These are just suggestions, I am trying to learn too..

Julie
 
Why would you code 96411 in case one but not case 2? I would code 96413, 96415 x 2, 96411 for both cases. I just passed by certification last month, so I'm not really sure. Any rationale will help me learn.
 
Administration Coding

If the two drugs are mixed together in the same bag, it's not concurrent (cannot bill 96368). The 96368 means a separate drug in a separate bag ran at the same time & you can only use that CPT once per treatment. If the Mesna's mixed with the Ifex & it's one bag, you're only going to bill 1 administration code, probably 96413 & 96415 for the 2nd hour of infusion. 96411 is for a chemo sequential push which I don't believe applies to your situation as you don't have anything else being pushed after the Mesna & Ifex. Hope this helps!
 
help

Why would you code 96411 in case one but not case 2? I would code 96413, 96415 x 2, 96411 for both cases. I just passed by certification last month, so I'm not really sure. Any rationale will help me learn.
Hi can you please email me @ nikkyoconnor@gmail.com I'm trying to get the certification I work as a infusion coder but I'm concerned about the contrast portion of the test, I appreciate your feedback.
 
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