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Oncology & Hematology Coding Alert

Reader Questions:

Post-Chemo Nausea Med Is Separately Reportable

Published on Sun Mar 20, 2005

Question: If we give a Medicare patient an intravenous dose of ondansetron after a chemotherapy infusion session of 58 minutes, can we report it separately from the chemotherapy?


Arkansas Subscriber

 
Answer: Yes, but only if you administer the ondansetron post-chemo. During chemotherapy sessions, oncology practices may use ondansetron to fight nausea. To code this scenario properly, you must know whether the ondansetron was delivered with the chemo or afterward.

If the practice gives a Medicare patient chemotherapy first, then administers the ondansetron, you should:
 

  •  report G0359 (Chemotherapy administration, intravenous infusion technique; up to one hour, single or initial substance/drug) for the chemotherapy.
     
  •  report G0354 (... each additional sequential IV push) for the ondansetron  infusion.

    For private payers, you should: 

  •  report 96410 for the chemotherapy.
     
  •  report 90784 (Therapeutic, prophylactic or diagnostic injection [specify material injected]; intravenous) for the ondansetron infusion. 
     
    Warning: If you administer the ondansetron during (concurrent with) the chemotherapy session, you should only report the appropriate chemotherapy administration code. 

    Clinical and coding expertise for this issue of Oncology Coding Alert was provided by Cindy Parman, CPC, CPC-H, RCC, co-owner of Coding Strategies  Inc. in Dallas, Ga.

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