Oncology & Hematology Coding Alert

Question: I heard that I should only report 90768 when the physician infuses a chemo drug and a therapeutic agent. Is this accurate?


Massachusetts Subscriber
 

Answer: You should report +90768 (Intravenous infusion, for therapy, prophylaxis, or diagnosis [specify substance or drug]; concurrent infusion [list separately in addition to code for primary procedure) in two situations:

1. the physician administers a chemo drug and a non-chemo drug through two separate bags

2. the physician administers two non-chemo drugs through two separate bags.
 
You should not report 90768 for the concurrent administration of two chemo drugs. Code 96549 (Unlisted chemotherapy procedure) is the most accurate code for  this service.

A note with 90768 tells you to report the code with 90765 (Intravenous infusion, for therapy, prophylaxis, or diagnosis [specify substance or drug]; initial, up to 1 hour) or 96413 (Chemotherapy administration, intravenous infusion technique; up to 1 hour, single or initial substance/drug).

But you should only report 96413 with 90768 for a chemo infusion provided concurrently with a non-chemo infusion.