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Need opinion on outpt chemo admin codes?

  1. Default Need opinion on outpt chemo admin codes?
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    Good afternoon,

    Intense coding discussion going on regarding proper use of 96413, 96417 and 96415. Your opinions would be greatly appreciated. Here is the coding scenario:

    Avastin: admin 13:19-13:50
    Irinotecan: admin 13:55-:1530

    We code:

    96413: for the Avastin
    96417: for the Irinotecan
    96415: addt'l time on the Irinotecan

    Another group wants to combine the time of the two ( Avastin & Irinotecan) make it 2 hrs 6 minutes and code only: 96413 and 96417. My interpetation is that you cannot combine the time of two drugs adminsitered seperately.

    Your thoughts?

    Thanks
    Mary Beth

  2. Default
    You are absolutely correct.

    96413- 1st hour of initial substance/drug, 96417- 1st hour of each additional sequential drug, 96415- each additional hr of primary or sequential drug. Coding one unit of each.

  3. Default
    Thanks for your response!

  4. #4
    Default chemotherapy drug administration
    Quote Originally Posted by mb1camacho View Post
    Good afternoon,

    Intense coding discussion going on regarding proper use of 96413, 96417 and 96415. Your opinions would be greatly appreciated. Here is the coding scenario:

    Avastin: admin 13:19-13:50
    Irinotecan: admin 13:55-:1530

    We code:

    96413: for the Avastin
    96417: for the Irinotecan
    96415: addt'l time on the Irinotecan

    Another group wants to combine the time of the two ( Avastin & Irinotecan) make it 2 hrs 6 minutes and code only: 96413 and 96417. My interpetation is that you cannot combine the time of two drugs adminsitered seperately.

    Your thoughts?

    Thanks
    Mary Beth
    I agree with 96413 and 96417 (total time 2hrs 11 minutes) I won't code for 3hrs when the document says administration was done only for 2hrs 11 minutes

  5. #5
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    It should be the 96413, for the 31 minutes of the Avastin, then 96417 for the first 1 hour of Irinotecan and 96415 for the last 35 minutes of the Irinotecan. So you are correct!

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