Results 1 to 6 of 6

Drug: Remicade

  1. #1
    Question Drug: Remicade
    Medical Coding Books

    Patient comes to our chemotherapy facility for administration of the drug Remicade and the patient does not have cancer, however this drug is infused the same way chemotherapy is admistered. How would you code this encounter? FYI: Remicade is a non-chemo drug? Infusion time is 1 hour.

    CPT 96413 - diag v58.11, 555.9

    same scenreio as above, although this patient has a breast cancer.

    CPT 96413 - diag v58.11, 555.9, 174.8
    Kristen Richard, CPC

  2. #2
    Overland Park Kansas
    Remicade is a monoclonal antibody so you can code it as 96413 with dx's 555.9 and V58.12 for patient A. Pt B can be coded the same way. Pt's can have two primary dx's but certain drugs are used to treat each dx. I wouldn't tie the breast cancer code to the Remicade if the Remicade isn't being used to treat the cancer.

  3. #3
    Thank you very much for your response. So you would use v58.12 instead of v58.11 because this drug is a non-chemotherapy drug? And would you use the 555.9 as the prime diag and the v58.12 as secondary diag? Because we always use v58.11 as prime when a patient is receiving an infusion.

    Thank you
    Kristen Richard, CPC

  4. #4
    Overland Park Kansas
    Well our Ingenix scrubs like for us to not have V codes as primary dx's so if there is a dx that we are using along with a V code then they would like for us to use it first and the V code second. Don't know why but I hear from others that it could be either way.

  5. #5
    I understand the primary V code discrepancy, for us it is always billed as primary if the patient is receiving an infusion....However can you please explain why you would use v58.12 instead of v58.11? Only becuase we have always used v58.11.

    Thank you,
    Kristen Richard, CPC

  6. #6
    Overland Park Kansas
    Sure, we use V58.12 for monoclonal antibodies and V58.11 for the other chemotherapy drugs.

Similar Threads

  1. J1745 Remicade
    By sbdg02 in forum Employment General Discussion
    Replies: 1
    Last Post: 05-24-2012, 06:46 AM
  2. Remicade Infusions
    By MSimmons89 in forum Billing/Reimbursement
    Replies: 0
    Last Post: 03-14-2012, 08:55 AM
  3. remicade injections
    By LAURIE0883 in forum Medical Coding General Discussion
    Replies: 0
    Last Post: 08-11-2011, 01:02 PM
  4. need help with remicade coding/billing
    By akrug in forum Hematology/Oncology
    Replies: 3
    Last Post: 01-01-2011, 07:36 PM
  5. Remicade Infusions
    By mcavanaugh in forum Gastroenterology
    Replies: 1
    Last Post: 11-03-2008, 08:27 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.