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Wiki Medicare changing administration billing

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valleycoder

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Did everyone see that Medicare is changing the administration billing method for patients who bring in their own meds?
 
Yes! Suddenly all 96413-96415 are being down-coded to 96365-96366. I have an inquiry into our MAC (Trailblazer) as to why these drugs are suddenly not considered as "highly complex" drugs even though I have documentation stating that they are...and why are they changing our codes without reviewing notes??
How is everyone handling this?
 
96413 and 96415

Lisa,

can you please help me?

when a patient starts today at 6:00 pm a chemo 96413 and have 7 more hours 96415 obviously will finish at 2:00 am, how should I code that? if the chemo continues to the next day?

thank you in advance for your help
 
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