Wiki Infusion Therapy

[AZ_coder22]

Hi all,
this is my first time posting, I'm not very confident in my hydration/infusion coding to begin with...and I am stumped on how to code a Pt's chart who came in to our UC for migraine therapy via infusion.

Pt has a long history of migraines and recently was given depacon/valproate sodium 500mg/5mL (100mg/mL) and magnesium sulfate 2g via IV as therapy, in addition to Morphine sulfate 10mgs via IV, and dexamethasone sod phosphate 1mg via IV. Pt was highly monitored for 1hr50mins. Pt has expanded history, detailed exam, and mod complex mdm.

I think this should be coded as:
99214-25, 346.90,376.10,784.0
96413-346.90,784.0
96417-346.90,784.0
96372-59, 346.90,784.0
96374-59, 346.90,784.0
J3490 (depacon)-346.90,784.0
J3475x4 (magnesium sulfate)-346.90, 784.0
J2270 (morphine)-346.90,784.0
J1100 (dexamethasone)-376.10

Any and all suggestions are welcome!!
Sarah
CPC-A

 

[OCD_coder]

96413 and 96417 are for chemotherapy and I am not seeing any chemo given.

You have two initials listed 96374 and 96413 and you can only have one per DOS. Were there two lines run, meaning were there two holes running into the patient somwhere and documented?
I need the start and stop times for each infusion to know what infusion codes were performed.
I suspect that you will have a 96365, 96366, 96375, 96372-59.

If you email me privately I will be happy to help you and share a cheat sheet that will make your life much easier.

 

[AZ_coder22]

Thank you so much for your reply.
The start stop time for the infusion was 3:20pm-5:30pm.

The codes you suggested support the documentation. And I understand what you meant about intiial-96413 and 96374. There was only one access site, so it can only be one or the other.


I thought it might be the 96413 b/c it says in the 2014 cpt book that "chemotherapy" includes other highly complex drugs or highly complex biological agents. I just wasn't sure if the POS would make it so (POS-20). The physician spent a lot of time monitoring this PT, and I feel like we should be reimbursed more than the usual...Do you see any issue with billing the J HCPCs codes the way I did?

 

[tlacagnina]

96367- how many times can you bill?

We are a chemotherapy / infusion office. We have been receiving refund request for billing 96367 4 times especially with FOLFOX regimens. This has not been an issue until recently. Did something change?

Pre Meds are given in seperate bags ( not mixed) :
Zofran
Benadryl
Decadron
Emend

We are now billing 96367 x 3 and 96366.

Is anyone else having this issue?

Thank you!

Tamara L. CPC