Oncology & Hematology Coding Alert

Reader Questions:

Code Chemo by Intended Service, Not Time

Question: Our patient was supposed to receive a Taxol infusion, but after five minutes he had a life-threatening reaction that required CPR. Should I still code the infusion, or should I code a push because it only lasted five minutes? And can I report the CPR? Ohio Subscriber
Answer: You should report the chemotherapy administration as an infusion that was discontinued because of the patient's health. Append 53 (Discontinued procedure) to 96413 (Chemotherapy administration, intravenous infusion technique; up to 1 hour, single or initial substance/drug). Although CPT guidelines- definition of -push- includes -an infusion of 15 minutes or less,- 96413-53 more accurately describes the service provided than a push code does (such as 96409, Chemotherapy administration; intravenous, push technique, single or initial substance/drug). Don't forget: If you-re coding for the drug, you should be able to report the entire amount, assuming you discarded it. Your documentation should describe the circumstances, the administration start and stop times, and the amount of drug delivered and discarded. And reporting V64.1 (Surgical or other procedure not carried out because of contraindication) will help indicate why the provider stopped the procedure. You may report the CPR with 92950 (Cardiopulmonary resuscitation [e.g., in cardiac arrest]).
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