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Thread: Medicare denials

  1. #1

    Default Medicare denials

    AAPC: Back to School
    Does anyone have an issue with Medicare denying the code 96366 when it is billed with the 96413 . The denial is stating that the code needs a preceding code??? I thought you cant bill another initial code with the 96413.
    PLEASE help me shed light..I am at a new oncology practice and I need to KNOW my stuff, and denials dont look good

    Thank you in advance

  2. #2

    Default Medicare denials for chemo infusions

    Wouldn't the add on code be 96415 instead of 96366? If you are billing initially for chemotherapy, your follow up code for additional time would also need to be for chemotherapy.

  3. #3
    Join Date
    Apr 2007


    I work in for an Oncology Practice and Chemo infusion 96413 for the first hour and to qualify for the second hour it must be at least 31 minutes. This is for chemo infusions. 96366 is for Theraputic infusion and its an additional hour so if you have antimetics given you would use 96367 for iv infusions ivp would be 96375 must be 15 minutes or less.

  4. #4


    Being that it is Medicare, possibly Q0084?

  5. #5


    Thank you all for your answers...
    I appreciate the time

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