Coding chemo infusion

[NishaJ]

Hi guys,

I need a clarification on Chemo infusion coding .Can any one share me any website for Chemo infusion coding..
And I have a doubt,Different chemo drug has given sequentially,for example Pentostatin given as sequential drug , and given for 2 hours, how to bill, while guideline mentioned as "Code 96367 is reported once per sequential infusion of the same substance".
AND whether we can add all the infusion time, and code from 99413, 99415 based on the infusion timing.Or need to code each chemo drug infusion separately...

Thanks.

 

[OncologyOKC]

sent PM

 

[ReneeGillam CPMA CMOM CMC]

chemo infusion coding

Hi

I am new to oncology.


Can you tell me when I should be applying the Z51.11 code to my chemo infusion procedure?

 

[OncologyOKC]

Per coding guidelines it should be billed on each chemotherapy encounter as the primary diagnosis, however, no carrier in my area processes claims properly when this is listed as primary. So just keep an eye on your claims for denials as you may have to make some changes to meet carrier specific requirments.

thanks!

 

[mitchellde]

the Z51.11 code is first listed only allowed. You cannot list this code as a secondary to meet a payer preference. The guidelines for ICD-10 CM coding are HIPAA mandated to followed and that means the payers as well as the providers. IF your drug is not chemotherapy then the Z51.11 is incorrect and this could be the problem not all drugs used to combat neoplasms are classified as chemotherapy. immunotherapy is coded as Z51.12, however if the drug is classified as a BRM then you would not use the Z51 codes at all you would code to the neoplasm.