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Oncology & Hematology Coding Alert

Reader Question:

Put Pump Questions to Rest

Published on Fri Feb 26, 2010

Question: Following up on "Factor In These Codes for FOLFOX4" in Oncology & Hematology Coding Alert, Vol. 12, No. 1, if we initiate a pump infusion for the patient, should I report 96425 for pump initiation and 96416 for prolonged infusion on the same date?Michigan SubscriberAnswer: In short, no. Rather than one code describing pump initiation and the other describing pump infusion, the two codes describe basically the same service (initiating a pump infusion that lasts more than eight hours). The distinguishing factor between them is that one is intra-arterial (IA) and one is intravenous (IV):• IV: 96416 -- Chemotherapy administration, intravenous infusion technique; initiation of prolonged chemotherapy infusion (more than 8 hours), requiring use of a portable or implantable pump• IA: 96425 -- Chemotherapy administration, intraarterial; infusion technique, initiation of prolonged infusion (more than 8 hours), requiring the use of a portable or implantable pump.The patient is not actually in the [...]
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