Wiki HIPEC billing and reimbursement

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lisa.reynolds@charter.net

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Hi all! I have a new client that does the HIPEC procedure(Heated Intraperitoneal Chemotherapy) during surgeries, however, we have had difficulty getting it reimbursed appropriately because the insurance companies are considering it experimental.
The codes we currently bill are as follows:
CPT code 77605; Hyperthermia, externally generated; deep (ie, heating to
depths greater than 4 cm)

CPT code (49419; Insertion of intraperitoneal cannual or catheter, with
subcutaneous reservoir, permanent (ie, totally implantable)

CPT code 96445; Chemotherapy administration into peritoneal cavity,
requiring and including peritoneocentesis.

Does anybody have any suggestions on billing HIPEC for maximum reimburement?
Thanks! -Lisa
 
HIPEC procedure

Hello, I am writing in response to the HIPEC procedure. I recently coded a HIPEC case as listed below.

Exploratory laparotomy, small bowel resection, tumor debulking and peritoneal chemotherpay perfusion(cytoreduction), possibe stoma - HIPEC procedure.

Exploratory laparotomy 49000
Small bowel resection 44120
Peritoneal chemotherpy 96446
Tumor debulking 49203

Yvonne D. Hinton, CPC
 
CPT 96446 and POS21

Hi everyvody, we had biilled for some HIPEC service and notice that procedure 96446 is most of the time denail because of POS 21.
Have you experience the same?
 
Hipec

I have also gotten denials for using 96446 in place of service 21. I am going to experiment using the "Unlisted chemotherapy" code 96549. Or did anyone have a better idea?
 
Hipec

Does anyone have any updates regarding this? One of my physicians is considering performing the HIPEC procedure. From what I am reading, it seems you should code 96549, 77605 for pseudomyxoma peritonei and diffuse malignant peritoneal mesothelioma. It sounds like some insurance companies will also cover carcinomatosis from colon, rectum, small bowel, and appendix, but ovarian cancer is not covered. Any updates would be greatly appreciated!
 
I know this is a rather old thread, but when there are coding changes, I like to update old threads since many people may reference them, not realizing the information is currently inaccurate. As of 01/01/2024 there is FINALLY a code (actually 2) for HIPEC.
96547 Intraoperative hyperthermic intraperitoneal chemotherapy (HIPEC) procedure, including separate incision(s) and closure, when performed; first 60 minutes (List separately in addition to code for primary procedure)
96548 Intraoperative hyperthermic intraperitoneal chemotherapy (HIPEC) procedure, including separate incision(s) and closure, when performed; each additional 30 minutes (List separately in addition to code for primary procedure)
Currently, there are no RVUs attached and pricing is per MAC, which should be interesting!
 
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