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 if several things were done it would fall under Q0085. Can you guide me on how to bill this?

New Jersey Subscriber

Answer: In a hospital setting, the 2002 CPT codes should not be used for chemotherapy administration or intravenous therapy. For these procedures, the HCPCS Q codes should be used. A chemotherapy administration regardless of the length of the infusion should be billed as Q0084 (Chemotherapy administration by infusion technique only, per visit). This is also classified in APC 0117.

When chemotherapy is administered by any method other than an infusion, such as subcutaneously or even IV push, use Q0083 (Chemotherapy administration by other than infusion technique only [e.g., subcutaneous, intramuscular, push] per visit). This is classified as APC 0116.

HCPCS codes vary significantly from the CPT codes used for chemotherapy administration billing in a private practice setting. When a chemotherapy infusion (Q0081) and chemotherapy given by another method (Q0083) are both used for the administration of the chemotherapy administration, Q0085 (Chemotherapy ... by both infusion technique and other technique[s]) should be used. This is classified as APC 0118.