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Wiki billing 96413

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tbragg36

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Bonita Springs, FL
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I'm stuck on a problem. We are infusing J2327 (Skyrizi) along with 36415 and 96413. UHC commercial plans are denying 96413 as exclusively as chemo therapy code. On the AAPC website I found the wording "96413 under injection and intravenous infusion chemotherapy and other highly complex drug or highly complex biologic agent administration". BUT in the CPT book for 96413 it says "chemotherapy administration, intravenous infusion technique: up to 1 hour". I'm getting conflicting information from the AAPC website to the coding book. Any thoughts out there on 96413 only chemo or can it be used for highly complex biologics?
 
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