Wiki Help with Chemo Codes

[kfusco]

I need help please in regards to some chemotherapy infusion coding. I am receiving a denial for the following codes being billed together:

96409, 96365, 96375 x2, J9190, J1100, J0640, J1626

Denied the 96365 stating, only one initial administration code (from all categories combined) is typically reportable for a given DOS. There is a more appropriate code for the reporting of this service.

I am new to coding chemo. Thank you for your help

 

[sls314]

I need help please in regards to some chemotherapy infusion coding. I am receiving a denial for the following codes being billed together:

96409, 96365, 96375 x2, J9190, J1100, J0640, J1626

Denied the 96365 stating, only one initial administration code (from all categories combined) is typically reportable for a given DOS. There is a more appropriate code for the reporting of this service.

I am new to coding chemo. Thank you for your help

You can only bill one Initial service. 96365 and 96409 are both initial codes.

Here's an article that shows the facility hierarchy. You'd want the infusion to be the initial service, and the push to be subsequent.

https://www.aapc.com/blog/84877-hows-your-infusion-hydration-and-injection-coding/

 

[kfusco]

You can only bill one Initial service. 96365 and 96409 are both initial codes.

Here's an article that shows the facility hierarchy. You'd want the infusion to be the initial service, and the push to be subsequent.

https://www.aapc.com/blog/84877-hows-your-infusion-hydration-and-injection-coding/

 

[kfusco]

Thank you for your help, I greatly appreciated it. Have a wonderful day