Oncology & Hematology Coding Alert

Question: What are the appropriate codes for the first day of the FOLFOX4 regimen? New Jersey Subscriber Answer: You should base your final coding decision on the documentation and the exact services your practice provides. But as a starting point, the FOLFOX4 regimen typically involves the patient receiving Oxaliplatin and folinic acid concurrently over two hours, followed by a 5-FU bolus on day one. That same day, the patient begins a 22-hour infusion of 5-FU, often using an ambulatory pump. In this scenario, your day one claim would include: • The Oxaliplatin (J9263, Injection, oxaliplatin, 0.5 mg) with 96413 (Chemotherapy administration, intravenous infusion technique; up to 1 hour, single or initial substance/drug) and +96415 (... each additional hour [List separately in addition to code for primary procedure]) • The 5FU (J9190, Injection, fluorouracil, 500 mg) with +96411 (... intravenous, push technique, each additional substance/drug [List separately in addition to code [...]