Administration coding

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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.
 

jrs7117

Networker
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Plant City, FL
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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
 
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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.
 

jbrandt

Contributor
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Columbus, OH
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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!
 

niurkasilva@yahoo.com

Contributor
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Cutler Bay, FL
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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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