Oncology & Hematology Coding Alert

Question: We began a chemotherapy infusion and ran it for two hours. The nurse stopped the infusion for a few minutes, and then restarted it. How should I code this treatment?

Louisiana Subscriber

Answer: Begin with 96413 (Chemotherapy administration, intravenous infusion technique; up to 1 hour, single or initial substance/drug) for the first hour and +96415 (- each additional hour [List separately in addition to code for primary procedure]) for the second hour. Because you can bill only one "initial" code per encounter, don't report 96413 for the second start-up; simply report +96415 again for additional infusion intervals. You can bill the infusion time based only on the time the drug was administered to the patient -- any time the drug is stopped cannot be counted as infusion time.