AAPC - Back to school
Results 1 to 5 of 5

Thread: Remicade w/ 96413 & 96415

  1. #1

    Default Remicade w/ 96413 & 96415

    AAPC: Back to School
    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
    Join Date
    Apr 2007
    Greeley, Colorado


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

  5. #5

    Default Remicade J1745

    If the Dr provided 4 Vials is that 40 Unit?

Similar Threads

  1. 96413 Medicare denial
    By sande78705 in forum Hematology/Oncology
    Replies: 2
    Last Post: 07-31-2014, 01:10 PM
  2. Initial Code 96413 & Sequential
    By YesicaRuedas in forum Hematology/Oncology
    Replies: 1
    Last Post: 06-03-2013, 06:34 AM
  3. 96413 + 96416
    By lgreen82 in forum Hematology/Oncology
    Replies: 1
    Last Post: 10-01-2012, 12:20 PM
  4. 96415 with modifier 52
    By pattivest in forum Hematology/Oncology
    Replies: 1
    Last Post: 05-21-2010, 05:19 AM
  5. Modifier 52 with 96415
    By pattivest in forum Modifiers
    Replies: 0
    Last Post: 05-20-2010, 06:40 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts

Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.