Vidaza administration question

[traci.susong@gmail.com]

If patient has a total does of 80mg of Vidaza (for example) and it is split into two syringes, how many 96401 are billed?

Same if it is split into 3 syringes for 170mg (syringe 1 - 50mg, syringe 2 - 50 mg, syringe 3 - 72 mg)?

 

[Mrshonda11]

Our office bills an administration code (96401) for each syringe given. I would love to hear from other oncology offices to see if they do the same. I have always wondered if this is the correct way to bill for subcutaneous vidaza.

 

[alannae]

I would bill for each shot given. What would be your concerns for not billing for each one?

 

[hmassimino]

I believe that it is correct to bill 96401 twice. It is the actual injection that is being billed, so when 2 injections are given, each one should be billed.

 

[admiller04@gmail.com]

Vidaza Administration Question

If patient has a total does of 80mg of Vidaza (for example) and it is split into two syringes, how many 96401 are billed?

Same if it is split into 3 syringes for 170mg (syringe 1 - 50mg, syringe 2 - 50 mg, syringe 3 - 72 mg)?

Unfortunately, only 1 drug admin can be charged. I realize sometimes it's split into seperate syringes for patient safety but when it's the facilities choice to provide in 2 (or more) syringes you still only get 1 admin. Now, if the package insert for the drug says to provide the drug in 2 separate syringes then you could get 2 admins.

Hope this is helpful!

 

[alannae]

I've been looking for clarification on this issue and am not having a lot of luck!

I did come across a link to this ASCO article in a previous post:

Billing for Multiple Injections or Intravenous Pushes of the Same Drug
http://jop.ascopubs.org/content/5/5/252.full

which states:

If a provider wishes to report multiple injections (intramuscular or subcutaneous) of the same therapeutic medication, he or she may choose to report code 96372 (therapeutic, prophylactic, or diagnostic injection [specify substance or drug]). The number of administrations would be reported as the units of service. Again, the provider will want to verify the billing guidelines with his or her local Medicare contractor.

I know it's not the same code but it is similar in that it is for an injection (not infusion). From this article, I would argue for billing multiple units.

The article also touches on multiple pushes issues as well.

Does anyone else have any references for these issues?