Oncology & Hematology Coding Alert

Question: Because Florida Medicaid does not reimburse for 90784, should I use 96410 instead? My colleague says that's incorrect coding. Who's right and why?

New York Subscriber

Answer: You should report 96410 (Chemotherapy administration, intravenous; infusion technique, up to one hour) for chemotherapy infusions, not a therapeutic infusion, which 90784 represents. Therefore, you should use 96410 only when the physician provides chemotherapy.  In addition, the National Correct Coding Initiative, version 10.2, considers 90784 an integral part of 96410, not a separate, sequentially administered procedure. This means you can't unbundle 90784 from 96410 with any modifier.