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confused? please help


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Do you select your chemo infusion codes according to the times given ex:

Taxotere given at 9:55 to 10:55 = 1hr


Herceptin given 11:00 to 12:30pm = 1hr 30mins

This can be coded 2 ways.

Can I code Herceptin as initial chemo code (96413) then (96415) for the addl 30mins or does Taxotere get the 96413?

Is the correct coding

1) 96413 Herceptin
96417 Herceptin
96417 Taxotere OR is it suppose to be

96413 Taxotere
96415 Herceptin
96417 Herceptin


Bettendorf, IA
Best answers
Hi Laurie -
The second example you coded would be accurate, but only if your Herceptin ran for 91 minutes. The 96415 is only billable if the drug ran for an additional 31 minutes or more after the initial hour. If your Herceptin truly did run for 90 minutes, you can only code the 96413 (Taxol) & the 96417 (Herceptin). You could always bill the Herceptin as the 96413 with the 96415 (as long as it was over the 90 min mark) and the Taxol as the 96417. As long as you account for each drug given and code based on the exact time the drugs were administered you will be fine. I hope this helps. Good luck!