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Remicade w/ 96413 & 96415

  1. #1
    Default Remicade w/ 96413 & 96415
    Clearnace Sale
    Can some one please direct me to the rule that states Remicade given for RA can be infused and charged using Chemotherapy CPT codes 96413 & 96415. Any infusions charged require a start and stop time, regardless of what they are, what they are for, or what type of facility is delivering them, correct? Also the J code for the Remicade indicates this is an injection. Is this HCPCS code interchangeable?

  2. #2
    The description prior to that section of codes includes the statement: "The term 'chemotherapy' in 96401-96549 includes other highly complex drugs or highly complex biologic agents." I coded for an infusion clinic for 1 1/2 years and we used the administration codes you mentioned above for Remicade. Are you using J1745 for the drug?

  3. #3
    Thank you~and yes J1745 is being used for the Remicade.

  4. #4
    Greeley, Colorado
    Those are the infusion codes we use and have no problems with reimbursement (so far).
    Lisa Bledsoe, CPC, CPMA

  5. Default Remicade J1745
    If the Dr provided 4 Vials is that 40 Unit?

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