Gastroenterology Coding Alert

Test your skills on these specific Crohn's  scenarios

Now that you've had a crash course in Crohn's disease, try your hand at coding these Crohn's-themed scenarios. 
 
Scenario 1: An established patient with Crohn's disease reports for a Remicade infusion. The physician administers the injection. The process takes two hours.
 
Scenario 2: A nurse practitioner administers a Remicade injection to an established patient with Crohn's disease. The entire visit takes one hour and fifty-eight minutes, and the physician is not present for the infusion.

Check Your Answers:

Answer 1: For the first hour of the procedure, report 90780 (Intravenous infusion for therapy/diagnosis, administered by physician or under direct supervision of physician; up to one hour). Use add-on code +90781 (... each additional hour, up to eight [8] hours [list separately in addition to code for primary procedure]) for the second hour. You should also report J1745 (Injection, infliximab, 10 mg) and J7050 (Infusion, normal saline solution, 250 cc) for the supply of the drug and saline.
 
Answer 2: Report 99211 (Office or other outpatient visit for the evaluation and management of an established patient, that may not require the presence of a physician ...) for the nurse's administration of the injection. Use add-on code +90781 (... each additional hour, up to eight [8] hours [list separately in addition to code for primary procedure]) for the second hour.
 
You should also report supply codes J1745 (Injection, infliximab, 10 mg) and J7050 (Infusion, normal saline solution, 250 cc).