AAPC - Back to school
Results 1 to 5 of 5

Thread: Coding Question

  1. #1

    Default Coding Question

    AAPC: Back to School
    I have an Oncologist that has asked the following: If a patient has labs done and after reviewing the labs he decides to change their chemo orders, is there a code that we can bill for high risk medication management? Can someone please help me with this?

  2. #2
    Join Date
    Apr 2007
    Bettendorf, IA


    Unfortunately I've not yet found any coding for situations like this. If it's 31+ minutes after the E/M service, you could always try a prolonged service charge (99358 - 99359) but it would require there be face-to-face time at some point. Good luck!

  3. #3
    Join Date
    Apr 2007
    Bettendorf, Iowa


    chemo drug monitoring is accounted for in the complexity of an E&M. It could help drive the E&M up a level but if the dr doesn't have face-to-face time I'm not sure there is anything you could use to bill for this on its own.
    Ruth Long CPC,CHONC

  4. #4
    Join Date
    Apr 2007
    Grand Rapids, MI


    Quote Originally Posted by earreid View Post
    If a patient has two drugs running at the same time (Chemo and IV Therapy) Do you code both or the Concurrent code as the initial drug?

    Also can 96416 be used with Chemo Infusion 15 min or less?
    I'm not sure what you mean by IV Therapy but two drugs running i.e. Leukovorin running concurrently, you would bill it as 96368. 96416 is for initiation of the pump only not a push 96411.

  5. #5
    Join Date
    Apr 2007
    Nashville AAPC Chapter


    96416 - the infusion has to run for more than 8 hours, so it would be a 96409 or 96411 as it is considered a push if it runs for 15 mintes or less.

    If Leucovorin is running concurrently into a different tubing into the patient, then yes you would use a 96368.

    Hope that helps.

Similar Threads

  1. Coding question
    By kristydews in forum Behavioral Health
    Replies: 1
    Last Post: 09-26-2011, 02:21 PM
  2. E/M coding with venipuncture coding question
    By gtaylor in forum Medical Coding General Discussion
    Replies: 3
    Last Post: 01-04-2011, 07:52 AM
  3. coding question
    By BarbLiimatta in forum Internal Medicine
    Replies: 2
    Last Post: 12-21-2009, 08:10 AM
  4. Coding Question
    By linhtran in forum Medical Coding General Discussion
    Replies: 1
    Last Post: 08-06-2009, 01:37 PM

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.