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Chemotherapy and therapeutic infusions

  1. #1
    Default Chemotherapy and therapeutic infusions
    Medical Coding Books
    Are the infusion codes based solely on time or on the number of different drugs administeredand time infused?
    Scenario: Chemotherapy infused for 3 hours, then another chemo is infused for 30 minutes, then a non-chemo in infused for 30 minutes. Wouldn't this be coded 96413x1, 96415x2, 96417x1, 96367x1, since there are 3 separate drugs?

  2. #2
    Hey dandellen,

    That is exaclty right, Just make sure that your first hour of any infusion is longer then 15 minutes (16min or more for 96413 and/or 96417) and each addl hour is longer than 30 min ( 31 min to qualify for 96415).

    If IV infusion is shorter than 15 or less you would have to bill the iv push code, if the additional hours are 30 minutes or less you would only qualify for one hour off iv infusion code.
    Last edited by ANGELAMM2004; 01-17-2009 at 11:38 AM. Reason: spelling error

  3. #3
    I am new to oncology coding and just starting to research the whole coding thing, my doctor injections the patients, intravenous, with a medicine to prevent nausea/vommiting then infuses one chemo drup and then another, so would i bill for the nausea/vomimiting medicine or would that be considered bundled ?

  4. #4
    Milwaukee, Wisconsin
    Chemotherapy is billed on time not the number of drugs administered or the order in which the drugs were administered. The main reason for the patients encounter for that date of service would be your primary code and everything else would be coded accordingly with subsequent codes. EX: Patient came in for chemotherapy treatment, your Primary code would be your first hour of chemo 96413 (IV-for infusions 16 minutes or greater) or 96409 IVP- if the infusion was less than 16 minutes . All other codes would be subsequent codes. Antiemetic drugs (for nausea and vomitting) can also be billed seperately for their infusion using subsequent codes depending on how they were administered and the amount of time of the infusion. Your non-chemo infusion codes would be 96375 (IVP) and 96367(IV) if the infusion was 16 minutes or greater. Hope this helps. Welcome to the wonderful world of Oncology coding!

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