Oncology & Hematology Coding Alert

Question: How many times may I report +90768 per encounter? Iowa Subscriber Answer: One time. When staff members administer multiple therapeutic, diagnostic, or prophylactic infusions through the same IV line, you should assign +90768 (Intravenous infusion, for therapy, prophylaxis, or diagnosis [specify substance or drug]; concurrent infusion [List separately in addition to code for primary procedure]). According to CPT's parenthetical note following +90768 in the manual, you should report the code only once per encounter. January update: CPT 2009 replaces +90768 with +96368 -- the digits are different, but the descriptor is the same. CPT 2009 also includes a note to report +96368 only once per encounter. How it works: The codes reimburse based on the additional work required for each separate administration. For additional drugs administered through the same route, you use subsequent, sequential, or concurrent codes. What are you infusing concurrently? Code +90768 is the "concurrent" code; you use it with one of these:
- 90765 -- Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); initial, up to 1 hour
- +90766 -- - each additional hour (List separately in addition to code for primary procedure)
- 96413 -- Chemotherapy administration, intravenous infusion technique; up to 1 hour, single or initial substance/drug
- 96415 -- - each additional hour (List separately in addition to code for primary procedure)
- 96416 -- - initiation of prolonged chemotherapy infusion (more than 8 hours), requiring use of a portable or implantable pump. Note: Like +90768, 90765 and 90766 get a digit facelift in 2009. CPT 2009 changes 90765 to 96365 and 90766 to 96366.