Wiki Therapeutic Infusion Pump???

[crhunt78]

Does anyone have experience coding for a therapeutic drug (Mesna) that is administered in a continuous infusion pump overnight? If the Mesna were mixed with Ifex, I would use the code for the chemo pump initiation, 96416, however, the Ifex is only being administered in the chemo suite/office and then the patient goes home with the infusion pump full of Mesna which runs until the next day.

Is there a CPT code for a continuous infusion of a therapeutic drug by pump or would it be coded as 96367, 96366 x 24 (if it ran for 25 hours).

I appreciate any help I can get on this one!

 

[crhunt78]

I came across the following information in a CPT Assistant Article: "The provider is cautioned not to assume that the 96000 series of CPT codes would be appropriately reported for every biologic response modifier, chemotherapeutic drug, or monoclonal antibody agent. For example, the CPT Editorial Panel Drug Infusion Workgroup addressed questions related to the infusion of Leucovorin and Mesna, drugs commonly utilized in addition to an antineoplastic agent infusion. The members indicated that although these drugs are included in the HCPCS Drug Category for Chemotherapy Drugs, their inclusion in the J9000 series was done as a matter of coding convenience as these drugs are not antineoplastic agents but either modulate the effect of the antineoplastic agent or protect normal tissues. The workgroup agreed that these drugs administered as modulating agents in addition to antineoplastic agent infusion should not be reported with codes in the 96000 series of codes but would be reported appropriately by a concurrent or sequential therapeutic infusion or injection code(s), depending upon the circumstances related to the hierarchy and method of administration."

Coding Communication: Drug Administration Services––Part 2 of 3
CPT Assistant June 2007, Volume 17, Issue 6, pages 4-6

 

[jbrown5]

I have only seen Mesna via prolonged infusion via portable pump coded with 96416. The code for non-chemo is code C8957. Refill and maint of the pumps if/when changed are different codes.

96416?Chemotherapy administration, intravenous infusion technique; initiation of prolonged chemotherapy infusion (> 8 hours), requiring use of a portable or implantable pump.

C8957 - Intravenous infusion for therapy/diagnosis; initiation of prolonged infusion (more than 8 hours), requiring use of portable or implantable pump