Oncology & Hematology Coding Alert

Question: For a drug called Navelbine (J9390) that needs to be "pushed" through an intravenous line, is it permissible to bill both a 96408 with modifier -59 and a 96410?

Nevada Subscriber

Answer: When chemotherapy is administered by different techniques, separate codes may be reported. For example, chemotherapy administration by the IV push technique is reported with code 96408 (chemotherapy administration, intravenous; push technique). If IV infusion techniques also are performed, then codes 96410-96414 (96410, infusion technique, up to one hour; 96412, infusion technique, one to eight hours; 96414, infusion technique, initiation of prolonged infusion, requiring the use of a portable or implantable pump) would be reported separately as appropriate. The drug would be coded with the appropriate J code in addition to the administration.

For every push administered drug, 96408 would be reported. Code 96410 would be coded for the first hour of infusion technique. If infusion lasted two hours, code 96410 would be listed with code 96412. Code 96412 is an add-on code and should never be listed alone. This code should be used to represent each additional hour up to eight hours.

Editors note: This question was answered by Laurie Castillo, MA, CPC, president of American Association of Procedural Coders Northern Virginia Chapter and a consultant with Physician Coding & Compliance Consulting in Manassas, Va.