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Ob-Gyn Coding Alert

Reader Question:

Coding for Chemotherapy

Published on Sat Sep 01, 2001

Question: We're going to start chemotherapy for a patient who has cancer of her vulva/vagina. These treatments consist of an application of 5FU. Should I code the application as destruction of lesions, or as an office visit?

Virginia Subscriber  
Answer: The answer depends on how the 5FU is applied, whether topically or injected into the lesions. If injected, use 96405 (chemotherapy administration, intralesional; up to and including 7 lesions) or 96406 for more than seven lesions, plus bill for the drug supply. You can also bill for an E/M service (99211-99215 with modifier -25), assuming one is documented.
 
If the 5FU is applied topically, bill for 56501 or 56515 (destruction of lesion[s] ...) plus the drug supply. Again, bill for an E/M service in addition to the destruction code only if one is documented.
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