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new to chemo

  1. #1
    Default new to chemo
    Medical Coding Books
    I am new to chemo coding and would love some help with this scenario.

    pt recieved:

    Zofran start 10:12 end 10:38
    Carboplatin start 11:00 end 12:12
    Etoposide start 12:25 end 13:56
    Compazine start 13:25 end 13:37

    What would be appropriate to bill for the compazine push adm?

    Thank you

  2. #2
    Default Compazine IVP
    Based on your scenario it would be appropriate to code compazine as 96375. Hope this information helps and Good Luck!

  3. #3
    Default
    Wondercoder~
    According to CPT guidelines, the 96375 is to be used fora "secondary or subsequent service." The Compazine was pushed concurrently with the Etoposide, therefore you cannot charge for the IVP of compazine. Hopefully this clarification didn't come too late. Best of luck!

  4. #4
    Location
    Grand Rapids, MI
    Posts
    57
    Default
    You can charge 96368 for concurrent x 1 for the compazine.

  5. #5
    Default
    Quote Originally Posted by abc1099 View Post
    You can charge 96368 for concurrent x 1 for the compazine.
    I am thinking that I cannot use the 96368 since the compazine is not an infusion so this code would not apply. Thank you for all responses on this case.

  6. #6
    Location
    Columbia, MO
    Posts
    12,838
    Default
    Quote Originally Posted by hnroberts View Post
    Wondercoder~
    According to CPT guidelines, the 96375 is to be used fora "secondary or subsequent service." The Compazine was pushed concurrently with the Etoposide, therefore you cannot charge for the IVP of compazine. Hopefully this clarification didn't come too late. Best of luck!
    Hmmmmm. I think they were referring to secondary to the initial not secondary meaning other services are no longer running. The difference between initial and secondary with infusions is vein access. If a vein is accessed only once then you can have only one initial code all others must be subsequent. So an infusion can be running and secondary to that access but while those fluids are infusion a push can be administered. Therefore the compazine can be coded with the 96375.

    Debra A. Mitchell, MSPH, CPC-H

  7. #7
    Default RE: Mitchellde's Response
    Quote Originally Posted by mitchellde View Post
    Hmmmmm. I think they were referring to secondary to the initial not secondary meaning other services are no longer running. The difference between initial and secondary with infusions is vein access. If a vein is accessed only once then you can have only one initial code all others must be subsequent. So an infusion can be running and secondary to that access but while those fluids are infusion a push can be administered. Therefore the compazine can be coded with the 96375.
    Debra -
    I'm not certain what your point is in regards to defining the difference between initial and secondary infusions and venous access. According to the CPT guidelines "Report 96375 to identify intravenous push of a new substance/drug if provided as a secondary or subsequent service after a different initial service is administered through the same IV access." The compazine in question was given while the subsequent chemotheraphy was running. When administering chemotherapy, it's not normal practice to have multiple venous accesses open, therefore your argument of "secondary infusions" is moot. If you don't have chemotherapy coding and billing experience I could understand how this mistake could be made, however, don't chide those of us who do have the experience and the credentials to back it up.

  8. #8
    Location
    Columbia, MO
    Posts
    12,838
    Default
    Quote Originally Posted by hnroberts View Post
    Debra -
    I'm not certain what your point is in regards to defining the difference between initial and secondary infusions and venous access. According to the CPT guidelines "Report 96375 to identify intravenous push of a new substance/drug if provided as a secondary or subsequent service after a different initial service is administered through the same IV access." The compazine in question was given while the subsequent chemotheraphy was running. When administering chemotherapy, it's not normal practice to have multiple venous accesses open, therefore your argument of "secondary infusions" is moot. If you don't have chemotherapy coding and billing experience I could understand how this mistake could be made, however, don't chide those of us who do have the experience and the credentials to back it up.
    OK, I was not "chiding" anyone nor did I make a mistake. I have several years of experience to back it up and do not wish to get into any argument over who's is bigger. I am pointing out the initial refers to the initial access of the vein. Only one initial service can be bill per vein access. after that every else is subsequent or concurrent. Yes the compazine can be billed as a subsequent service. Using the same quote per CPT you use the 96375 after a different initial service, it does not mean after the infusion is completed it mean after the initial access to push a drug via the same access must be billed as a sequential service. Most pushes are administered while other fluids are infusing. This is why you cannot bill initial IV push. Pardon while I disagree with you respectfully.

    Debra A. Mitchell, MSPH, CPC-H

  9. Default
    Agree 100% with Deb. You CODE THE IVP of Compazine with 96375. End of story.

  10. #10
    Default
    Quote Originally Posted by WonderCoder View Post
    I am new to chemo coding and would love some help with this scenario......
    What would be appropriate to bill for the compazine push adm?

    Thank you
    Ultimately, we all may interpret the CPT guidelines differently. The claim will only get paid if you follow the guidelines as set forth by your payer and their interpretation of the CPT guidelines. Check the LCDs for your area and for your payers. Good luck in the future!

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