Question Billing 96416 for more than 1 drug

kathleeng

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How to bill initiation of pump for 3 drugs given for 1 pump- I know 96416 is for the initiation and can only be billed once, however I'm trying to determine what code do we use to bill a secondary drug initiated on the same pump. Guidelines state: "Do not report the initial infusion code, 96416, for subsequent infusions using the same pump. And do not use refill code 96521 for initiation.", but no further clarification is found on what code to use for subsequent infusions using the same pump on same encounter. Any feedback on this area?
 

kathleeng

Guru
Messages
104
Location
Fresno, CA
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Hi Kathleen, Are the 3 drugs part of a chemotherapy regimen?
Yes, they are all part of chemo regimen. However I found that 2 pumps were set to infuse 3 drugs in parallel for continuous IV over 24 hour period. I'm thinking we would only bill 1 admin code since all set to transfuse over same period of time... ?
 
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