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Thread: Continuous Pump

  1. #1

    Default Continuous Pump

    AAPC: Back to School
    I have a situation that hasn't happened here before and wondering how to code it. A patient came in for a 3 day continuous pump to be put on. He returned the following day because there was a leak and had to be completely reaccessed. The pump was completely disconnected, physician added Avastin, chemo re-calculated then the pump was re-connected. In this case can I charge for the 96521 and the 96416 with a modifier?

    I appreciate anyone's help.

  2. #2


    I have questions along the same line. Patient coming in for 5FU and mitomycin in the pump on Monday, will be sent home and then return on Wednesday for refill of the pump. How would I code this? 96416 on Monday and WEdnesday and then a disconnect on the 5th day? 96521? Also if you bill 96521, are we able to bill E/M code with it?? Please help as I am really at a loss as how to bill this patient. Thank you

  3. #3
    Join Date
    Apr 2007


    1) For the pump that was disconnected/reconnected you can only bill for the initiation 96416. You can't bill for the refill because it was disconnected due to a problem with the pump.
    2) For the pt given 5FU/mitomycin you would bill on Mon. a 96416, on Wed. 96521, and on the 5th day disconnect. As long as they are adding something in the pump on Wed. then you can bill for the refill.
    3) E/M same day as pump initiation/refill, as long as it medically necessary you can bill one with a modifier 25.
    Stephanie Thebarge, CPC, CEMC, CHONC
    Portland AAPC Chapter President
    Coding Compliance Specialist
    Feel free to message me with questions

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