nycoder
Contributor
Hello,
This question pertains to an outpatient hospital setting: We are seeing many encounters for prolonged chemotherapy infusion requiring the use of a pump but only lasting 2-3 hours max. The most appropriate CPT code seems to be 96416 but that code specifies that the infusion should be "more than 8 hours". Is it ok to use Modifier 52 for reduced services in this instance?
We have considered using code 94613 with 96415 as an add-on for each additional hour but these codes do not include the use of "a portable or implantable pump".
Any help anybody can offer would be greatly appreciated,
Thanks
This question pertains to an outpatient hospital setting: We are seeing many encounters for prolonged chemotherapy infusion requiring the use of a pump but only lasting 2-3 hours max. The most appropriate CPT code seems to be 96416 but that code specifies that the infusion should be "more than 8 hours". Is it ok to use Modifier 52 for reduced services in this instance?
We have considered using code 94613 with 96415 as an add-on for each additional hour but these codes do not include the use of "a portable or implantable pump".
Any help anybody can offer would be greatly appreciated,
Thanks