Oncology & Hematology Coding Alert

Question: What CPT code should I use for chemo administration into the peritoneal cavity through a peritoneal port? We-re considering 96445 and 50391. We-re in a facility-based chemo clinic. Pennsylvania Subscriber
Answer: Code 96445 (Chemotherapy administration into peritoneal cavity, requiring and including peritoneocentesis) is the most appropriate code for this service. Snag: The descriptor says -requiring and including peritoneocentesis.- If you don't perform and document peritoneocentesis as part of the chemotherapy administration, your payer may require you to append modifier 52 (Reduced services) to 96445 to indicate that you did not perform the full code description. Code 50391 (Instillation[s] of therapeutic agent into renal pelvis and/or ureter through established nephrostomy, pyelostomy, or ureterostomy tube [e.g., anticarcinogenic or antifungal agent]) would not be appropriate because this describes administration of medication into the renal pelvis and/or ureter through the tubes listed in the descriptor, which don't include a peritoneal port. You-d typically report 50391 when you treat urothelial tumors, according to CPT Changes: An Insider's View, 2005.