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Thread: 96368 concurrent infusion

  1. #1

    Default 96368 concurrent infusion

    Could someone please give me an example of an appropriate use of 96368, concurrent infusion? Should this code ever be used for chemo drugs or is this strictly for therapuetic/diagnostic drugs? Also, the documenation should show that the drugs were administered from 2 bags, correct?

  2. #2
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    Cisplatin and Leucovorin is a treatment plan that would be an example of a concurrent infusion.

    Think of concurrent as two railroad tracks going into the patient in two different lines at the same time. The Cisplatin would be run into the port and the Leucovorin would be run into the dorsal site of the patient's arm.

    96413-Cisplatin 1st hr
    96368 - Leucovorin 1st hr

    We have been having to append a mod-59 to the 96368 to get them to pay showing that they are at different sites.

    Hope this helps.

  3. #3
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    if you have two separate lines in two separate locations on the patient then you may bill for 2 initial infusions using the 59 modifier. The initial refers to the initiation of the service into the vein site. If you have one line (even if that line has a separate lumen such as a Y connector) and you hang a second bag CONCURRENTLY then you bill the concurrent infusion code.
    : The AMA defines a concurrent infusion as one in which two drugs are simultaneously infused or multiple infusions are provided through the same intravenous line.
    Note: Multiple substances mixed in one bag are considered to be one infusion, not a concurrent infusion.
    There is no concurrent code for hydration
    The concurrent CPT/Charge is limited to unit of one regardless of the duration of the concurrent infusion

    Debra A. Mitchell, MSPH, CPC-H

  4. #4
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    so if we are funning Oxaliplain and Leucovorin simuntaneously and they run for 2 hours each would you use 96386 and 96366 for the Leucovorin? or would it be 96386 only?

  5. #5
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    Are they in 2 separate bags? If so you will code one as initial and the other as concurrent.

    Debra A. Mitchell, MSPH, CPC-H

  6. #6

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    If you have for example:

    Oxaliplatin given 9:33-12:15 (135mg) and Leucovorin calcium (run concurrently w/ Oxaliplatin) given 9:33-12:15 (632mg) is it appropriate to bill the 96413, 96415 x 2, and 96368 or would you bill as 96413, 96415 x 2, 96368, 96366 x 2 for the additional 2 hours that the Leucovorin calcium was running? I know we can only report the 96368 once per session, but can we bill for the additional hours that the leucovorin is running?? If anyone knows and can direct me to some documentation I can read, I would really appreciate it!

  7. #7

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    and these would both be in separate bags, sorry..

  8. #8

    Unhappy when to bill 96368

    not speaking in chemo thearpy drugs, if you have pepcid starting @ 18:12 ending @19:52, then NACL running @18:19 with end time of19:03, Soul Medrol given @ 18:12.what CPT codes do I use?

  9. #9

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    LLcoder,

    For the example you gave. you would bill 96413, 96415x2 and 96368.

    The 96368 is not a time based code. So you would not bill the 96366.

    Alanna

  10. #10

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    I have a question regarding 96368.
    This is the scenerio:
    Alimta 1535 - 1545 = 96409 (initial Chemo IV Push)
    zofran 1450 - 1510 = 96367 (sequential infusion)
    Decadron 1450 - 1510 = 96368 ?
    Wouldnt Decadron be coded 96368 since it is a concurrent sequential infusion to Zofran?
    Thank you,
    Michelle

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