Wiki infusion coding

[jo holsapple]

When to use mod 59 in infusion coding?
Should I use mod 59 on the pushes? or only use on SQ or IM injections
96411
96375
If a patient got
96413
96417
96411-59
96367
96375-59
would this be correct codes?

or on these codes
96372
96401
96402

example
96413
96417
96367
96372-59
96401-59
which is the correct?
thanks
Jo

 

[peggy@pronetsystems.net]

You only use the 59 modifier if the CPT code is outside the heirarchy of infusions. You would not use the 59 on an add-on code like 96411. If you are a physicians office you do not need to use the heirarchy, but I find it easier. Remember Chemo trumps therapeutic drugs which trumps hydration. Infusion trumps push which trumps injection. It is REALLY IMPORTANT to read the notes at the beginning of the "Hydration, Therapeutic, Prophylactic, Diagnostic Injections and Infusions and chemotherapy and Other Highly Complex Drug or Highly Complex Biologic Agent Administration".

 

[mjb5019]

Cutting Edge article

There is an infusion article inthe February issue of Cutting Edge. It's available online if you don't have your copy handy.