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96416 or 96521

  1. #1
    Location
    Spokane WA
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    11
    Default 96416 or 96521
    Medical Coding Books
    A pt had an initiation of prolonged infusion requiring pump on 2-23-10, then had it refilled 3-2, 3-9, 3-16, 3-23 and 3-31-10. Pt was back in on 9-13-10 and was billed 96416, initiation again. Is there a time limit between initiation charges? Thanks for your help.

  2. #2
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    Quote Originally Posted by Wendy CPC View Post
    A pt had an initiation of prolonged infusion requiring pump on 2-23-10, then had it refilled 3-2, 3-9, 3-16, 3-23 and 3-31-10. Pt was back in on 9-13-10 and was billed 96416, initiation again. Is there a time limit between initiation charges? Thanks for your help.
    You should bill the 96416 every time you initiate the pump. If you are physically hooking up the pump, that is an initiation. If the patient returns to your office and you change the drug cassette and perform a cleaning then you use the 96521 refill code. In the scenerio you list above, each would be an initiation of a pump unless the drug was infused over the 7 day period between visits.

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