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Help with 96416/cytoxan over 3 hours

  1. Default Help with 96416/cytoxan over 3 hours
    Medical Coding Books
    Pt is receiving chemo in the clinic, including cytoxan x3 hours. The pt is then sent home with portable pump x2: first pump is for cytoxan which is to run over 3 hours and the second pump is for hydration which will run for 24 hours.
    The clinic time infusion is being coded with 96413/96415 as documented, but for the pump infusion at home---since the chemo itself is not running for 8+ hours, what are the best codes to use?

  2. #2
    Nashville, TN
    I think it would depend on whether the pump is being initiated or refilled. The code description for initiation (96416) specifically says it has to be >8 hours, but 96521 just says refill and maintenance of portable pump.

    So I would bill the 96413, 96415x2 for Cytoxan and 96521 for pump refill.

    Len Hales, RN, BSN, CPC

  3. Default
    Thank you Len. That was what I was leaning toward.

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