Oncology & Hematology Coding Alert

Knock +96415, +96417 Claims Out of the Park With This Case Study's Help

Take the mystery out of 'each additional sequential infusion' vs. 'each additional hour.' If you fall prey to a common subsequent infusion trap, you could face requests for multiple $40 refunds. Keep your hard-earned dollars with this look at reporting additional hours of subsequent chemotherapy infusions. Is +96417 x 2 the Proper Choice? Scenario: You've coded a patient's initial chemotherapy infusion. Now you need to code a subsequent chemotherapy infusion that lasted longer than 90 minutes. You determine that for the subsequent infusion's first hour, you should report +96417 (Chemotherapy administration, intravenous infusion technique; each additional sequential infusion [different substance/drug], up to 1 hour [List separately in addition to code for primary procedure]). Now you have to decide how to report the additional time beyond that hour. Should you report +96417 again or report +96415 (... each additional hour [List separately in addition to code for primary procedure])? Solution: The [...]
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in your eNewsletter
  • 6 annual AAPC-approved CEUs*
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more
*CEUs available with select eNewsletters.