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Cpt 96416


Local Chapter Officer
Best answers
I work with various hospital outpatient departments that bill for initiation of prolonged chemotherapy infusions using CPT 96416. At present, a few of these hospitals are experiencing denials of CPT 96416 when reported alone. In the past, the 96416 was not a "sequenced" code. Does anyone have any clarification of how 96416 should be handled (sequenced or not sequenced with the Chemo/Infusion hierarchy)? If possible, would like the reference used to determine the use of the code vs. what has been successfully used (without a reference). Thanks in advance!