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Infusions stopped and re-started

  1. #1
    NCF Gainesville
    Default Infusions stopped and re-started
    Medical Coding Books
    Hi Guys!

    Quick question for you. If a chemo infusion was started, then stopped due to a reaction, and then the same medication restarted later, do you add up the total time to calculate the time for that drug or do you treat it as two seperate infusions?

    And do you have any source documents to back this up?

    In my research I have found both answers!

    Last edited by jas0426; 07-27-2011 at 10:41 AM. Reason: Wrong signature

  2. #2
    This link might help:

    Question 1: If we do a IVPB test dose of a chemo drug (1 hr infusion time) then administer the remainder of the drug over 2 hours, is the test dose coded as additional or sequential?

    Question 2: If we do an IVP as a test dose on a chemo drug then an infusion of the drug IVPB, how do we code? Include the push time or code separately for the IVP?


    I have no reference to provide for these questions, however, I believe in Question one the test dose infusion of the chemo drug will be your initial infusion with the remainder of the drug billed as additional hours even if there is a short interval between these two services. The Scenario #2...

  3. #3
    NCF Gainesville
    Thanks! There was another drug given in between so I am leaning more towards two seperate infusions. I just need some proof to back that up....thanks again!


  4. Default
    We have the same issues. If a patient has Rituxan and has an allergic reaction and it is stopped and restarted. It is appropriate to add the total time of the infusion, not counting the time you provided the reaction meds (i.e. Benadryl ect.).

    We use CPT 86486 skin test unlisted antigen for test doses.

  5. #5
    Bettendorf, Iowa
    Because its the same drug, even though it was stopped, you would add up the total time the drug was administered, excluding the time it was stopped.

    so if you administered rituxan:
    start 1200 stop 1230
    start 1330 stop 1530

    total admin time is 2hr and 30 minutes: 96413 + 96415
    You cannot bill for the 1 hr it was stopped

    You can only use 96413 once per encounter. 96417 is only for additional sequential infusion of a different substance. These definitions can be found in the CPT manual.
    Ruth Long CPC,CHONC

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