Only one initial code is allowed per patient encounter unless two separate IV sites are medically reasonable and necessary (use modifier 59). If the patient returns for a separate and medically reasonable and necessary visit (encounter) on the same day, another initial code may be billed for that visit with modifier 59.
Remember chemotherapy is billed by the time not the drug or how many times the drug was used.
In your case, how you would currently code is correct and no you would not count the second Nitro IC at 11:53.
I hope this helps, here are two links that can sometimes be helpful, also always review the CMS website: https://www.noridianmedicare.com/pro...cs/MR_FAQs.pdf
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