Oncology & Hematology Coding Alert

Question: We are a hospital-based oncology clinic, and the hospital wants us to bill all chemotherapy and infusions under Q0084. I thought that if the treatment was longer than an hour or several things were done, it would fall under Q0085. Can you tell me how to bill this?

New Jersey Subscriber

Answer: Use of these Q codes raised a lot of questions during the first half of 2002 because they were erroneously deleted from the 2002 HCPCS manual. In fact, they continue to be valid codes.

You should bill chemotherapy infusions, regardless of the duration of the infusion, with Q0084 (Chemotherapy administration by infusion technique only, per visit). This code can be billed only once per visit, even if multiple chemotherapy infusions are given. When a chemotherapy infusion and chemotherapy agent are administered by IV push or any other technique during the same visit, you should assign Q0085 (Chemotherapy administration by both infusion technique and other technique[s] [e.g., subcutaneous, intramuscular, push], per visit). Again, this can be used only once regardless of the number of agents administered. For IV infusions that are not chemotherapy, you should use Q0081 (Infusion therapy, using other than chemotherapeutic drugs, per visit).

Q0084, Q0085 and Q0081 must be used in hospital settings with APC codes instead of CPT codes.