Oncology & Hematology Coding Alert

Question: Our physician administered decadron and aloxi as an intravenous piggyback infusion during an encounter for chemotherapy. The infusion lasted 19 minutes. Can we submit code 96368 for this infusion?

Connecticut Subscriber

Answer: It is incorrect to submit code +96368 (Intravenous infusion, for therapy, prophylaxis, or diagnosis [specify substance or drug]; concurrent infusion [List separately in addition to code for primary procedure]) when drugs are combined in the same bag (“infusate”). You can best report the infusion of this single infusate with one unit of +96367 (Intravenous infusion, for therapy, prophylaxis, or diagnosis [specify substance or drug]; additional sequential infusion of a new drug/substance, up to 1 hour [List separately in addition to code for primary procedure]). Note that +96367 is an add-on code and you can submit this code along with the initial chemotherapy administration code which is the main reason for the encounter.

Don’t forget, both drug HCPCS “J” codes can also be reported in this instance, even though you only have a single 96367 infusion code.