Oncology & Hematology Coding Alert

The October/November 2003 Oncology Coding Alert article "How to Use Modifier -59 to Unbundle Chemotherapy Codes," page 78, stated, "You should report the first hour of chemo as 96410-59 ..." This sentence should read, "For the first hour of chemotherapy, report 96410 (Chemotherapy administration, intravenous; infusion technique). Do not attach modifier -59 (Distinct procedural service) to 96410."
 
The article also stated, "... for the additional hour [of chemotherapy] use 96414-59." But you should bill +96412 (... infusion technique, one to 8 hours, each additional hour [list separately in addition to code for primary procedure]) in addition to 96410, because 96412 represents each additional hour up to eight hours. You don't have to attach modifier -59 to 96412, because 96412 is an add-on code. Also, don't report 96412 alone.
 
Regarding 96414 (... infusion technique, initiation of prolonged infusion [more than 8 hours], requiring the use of a portable or implantable pump), you can attach modifier -59 to that code when the oncologist begins a prolonged infusion on the same day after in-office chemotherapy administration that included 96412. Use 96414 for situations that require a portable or implantable pump for more than eight hours.
 
In addition, the erroneous information in the above paragraph was inadvertently attributed to Linda L. Lively, MHA, CCS-P, RCC, CHBME, president and chief executive officer of AMAC, a coding consultant firm in Atlanta.