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oncolody coding question


Best answers
Hi I work for an oncology practice in Arkansas and arkansas medicaid has only been paying 1 unit on procedure code 90767 even though we may use 3 or 4 units. Does anyone know if they should be paying more units or can anyone tell me where I can find this information? I have searched the medicaid website and it is not there. I would greatly appreciate it! Thank you
San Diego, CA
Best answers

Cpt description of 90767 is "... up to 1 hour", which would mean that you cannot bill more than one unit of this code. The cpt book actually says "report 90767 only once per sequential infusion of same infusate mix". Are you infusing different mixes of infusate?

Have you taken a look at cpt code 90766? The cpt book says that to report this code for "infusion intervals of greater than 30 minutes beyond 1 hour increments".

I would think that you would use a combination of both these codes to bill for the total infusion time.

Hope this helps & good luck!