Wiki Prolonged infusions G0498 vs E0781 and 96416

kathleeng

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So I know G0498 encompasses 3 components: the initiation in office, the continuation at home, and the follow up in office at conclusion of infusion, along with the supplies/device, however when would you choose this code versus choosing to bill the E0781 along with the initiation code 96416? I can't seem to determine what the difference would be if both times we either own or rent the pump and are initiating in office and sending patient home for 8 hours or more. Also, if we do bill G0498 and the patient returns to office but not to discontinue but to refill, would we then bill for the refill and maintenance, although the pump was never separately billed? Last question, is there a set amount of time that needs to be spent in order to qualify for initiation of G0498? Any feedback would be greatly appreciated.
 
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