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Thread: Medicare Billing for Hospital Infusions

  1. #1
    Join Date
    Apr 2007
    Fort Worth, Texas

    Default Medicare Billing for Hospital Infusions

    AAPC: Back to School
    What procedure codes would I use to bill for a hospital inpatient receiving Ceftriaxone 1 gram IV (J0696) and Zithromax 500 mg IV (J0456), once a day for 10 days?

    Same patient, but receiving the infusion via outpatient hopital infusion center - OPPS (Medicare)?

  2. #2

    Default Is this a trick question?

    Inpatient services are paid by DRG weight, the only procedure codes used are ICD-9 four digit procedure codes.

  3. #3
    Join Date
    Apr 2007
    Columbia, MO


    I am curious if you are coding for the facility. An inpatient coder will use the ICD-9 volume 3 codes for the procedures. An outpatient coder will probably not code these at all, every outpatient facility I have worked in across the US, have infusion codes driven thru the chargemaster. So it is curious as to the nature of your question and in what capacity you work, as in facility or physician based.

    Debra A. Mitchell, MSPH, CPC-H

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