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IV infusions

  1. #1
    Default IV infusions
    Medical Coding Books
    What if the IV infusions are two different drugs running concurrently for 2 hours and another chemo push ?

    Would that be coded as 96413, 96417, 96411 ?? Also when coding for chemo do you need to add modifier's to these procedures ?

  2. #2
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    I am short my book right now but it should be initial infusion, concurrent infusion and subsequent push.

    Debra A. Mitchell, MSPH, CPC-H

  3. #3
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    Quote Originally Posted by cpccoder2008 View Post
    What if the IV infusions are two different drugs running concurrently for 2 hours and another chemo push ?

    Would that be coded as 96413, 96417, 96411 ?? Also when coding for chemo do you need to add modifier's to these procedures ?
    Since the two chemo drugs are in the same bag and concurrent you would bill 96413 - 1 unit for the first hr, 96415 - 1 unit for the second hr and 96411 - 1 unit for the additonal push

  4. #4
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    thank you,, at least i got 2 out of 3 correct. That mean's i am on the right track !! lol

  5. #5
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    Do you have to apply modifier's to chemo codes ?? Also what if a patient is sent home with a pump, do i bill 96416 and the next day when the complete treatment or return the pump i don't bill anything ??

  6. #6
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    Quote Originally Posted by cristig4 View Post
    Since the two chemo drugs are in the same bag and concurrent you would bill 96413 - 1 unit for the first hr, 96415 - 1 unit for the second hr and 96411 - 1 unit for the additonal push
    Were they in the same bag? I understood when you said concurrent that it was two drugs two bags.

    Debra A. Mitchell, MSPH, CPC-H

  7. #7
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    Quote Originally Posted by mitchellde View Post
    Were they in the same bag? I understood when you said concurrent that it was two drugs two bags.
    I honeslty don't know, i'll have to ask the nurses.

  8. #8
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    I would say no according to this article they are seperate. http://en.wikipedia.org/wiki/FOLFOX

    Oxaliplatin 85 mg/m² IV infusion in 250-500 mL D5W and leucovorin 200 mg/m² IV infusion in D5W both given over 120 minutes at the same time in separate bags using a Y-line, followed by 5-FU 400 mg/m² IV bolus given over 2-4 minutes, followed by 5-FU 600 mg/m² IV infusion in 500 mL D5W (recommended) as a 22-hour continuous infusion.

    After reviewing this i came up with 96413, 96417, 96411, 96416. The 96413 is for the initial infusion of Oxaliplatin, the 96417 for the subsequent concorrent Leucovorin, the 96411 for IV push and 96416 for the infusion over 8 hours.

  9. #9
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    Sioux Falls, SD
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    I thought you had two chemotherapy drugs. Leucovorin is not a chemotherapy drug. The following is from the leucovorin website:
    What is Leucovorin?
    Leucovorin is a drug that can be used either to protect healthy cells from chemotherapy or to enhance the anti-cancer effect of chemotherapy.
    In that respect the codes would be 96413 - initial hr for oxal, 96415 - second hr oxal, 96368 - concurrent infusion for the leucovorin. If there is an actual push of a chemotherapy drug you can bill 96411. If it is a push of another med such as aloxi that is coded with a 96375.
    If pt is hooked up to a pump then yes you bill 96416 the day they start the pump. You may charge a 99211 for disconnecting the pump the following day if there are no other qualifying services.
    There should be no modifiers for the chemo codes.
    Hope this helps, Cris

  10. #10
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    We are billing for the Oncologist only. This is a brand new service to our company so we aren't too familiar with it's coding so i really don't know what drugs are chemo and which one's aren't. I get a list of the chemo drugs used and a charge sheet that looks like a anesthia sheet starting the start and stop time and they way it was administered. This patient had an Oxaliplatin and Leucovorin infusion with a fluorouracil push and sent home with a CADD pump with fluorouracil. Does that make sense ?? This is my second chemo i am trying to code and the first one had a fluorouracil and Leucovorin push. I just thought they were both chemo drugs because on my charge ticket it is listed under chemo drugs, not with the pre-medication drugs or other drugs used. We don't bill for nurse's so we can't bill the 99211, we are only billing the admit of the drugs for the physician. I was told i couldn't bill for anything else because we don't own the drugs or the nurse's. I am sooo very confused !!!

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