Oncology & Hematology Coding Alert

Reader Questions:

Don't Code Disconnect Without Checking Payer

Question: Is there a 24-hour pump disconnect code, or should we code an office visit?

Connecticut Subscriber

Answer: There is no separate pump disconnect code.

Many payers consider the disconnection to be incidental to the initiation (96416, Chemotherapy administration, intravenous infusion technique; initiation of prolonged chemotherapy infusion [more than 8 hours], requiring use of a portable or implantable pump).

Other payers may allow you to report the disconnection separately with a low-level E/M service code, such as 99211 (Office or other outpatient visit for the evaluation and management of an established patient...). As always, documentation should support any CPT code you bill.

Clinical and coding expertise for You Be the Coder and Reader Questions provided by Kelly C. Loya, CPC-I, CPhT, managing consultant with Sinaiko Healthcare Consulting Inc.