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prolonged infusion pump

Rita Bartholomew

Rita Bartholomew

Guru
Messages
130
Location
Greater Portland (Maine)
new coding scenarios for our hospital-based Oncology practice:
1st scenario: pt comes in & gets hooked up to a prolonged infusion pump...sent home for prolonged infusion & returns 2 days later for a disconnect.
2nd scenario: Pt is in for an "in-clinic infusion"...after completion, pt is hooked up to a prolonged infusion pump for add'l infusion at home...returns 2 days later for a disconnect. Do we bill for the pump (96416) in addition to the days infusion...also, do we bill for the disconnect?
 
Hi Rita,




1st scenario: pt comes in & gets hooked up to a prolonged infusion pump...sent home for prolonged infusion & returns 2 days later for a disconnect.
For the first scenario, you would code 96416 for the prolonged infusion pump start and then when the patient returns for the disconnect you can bill 96521 (which is "refilling and maintenance of portable pump"


2nd scenario: Pt is in for an "in-clinic infusion"...after completion, pt is hooked up to a prolonged infusion pump for add'l infusion at home...returns 2 days later for a disconnect. Do we bill for the pump (96416) in addition to the days infusion...also, do we bill for the disconnect?

This would be the same answer and codes however on the day of chemo when the patient is hooked up to the pump, if he has other infusions, you put a 59 modifier on the 96416
 
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