Oncology & Hematology Coding Alert

Improve pay with Medicare's new pushtechnique guidelines

Does your oncologist provide multiple drugs during chemotherapy administration? If so, you can now report push infusion code 96408 per drug used, a new rule the 2004 Medicare Physician Fee Schedule introduced on Jan. 1.
 
Generally, oncology coders report 96408 (Chemotherapy administration, intravenous; push technique) when the physician provides chemotherapy drugs using the push technique. Prior to the 2004 fee schedule, you could bill 96408 only once per day, regardless of how many drugs the physician administered, according to CMS transmittal 34, published on Dec. 24, 2003.
 
But now you can assign 96408 more than once per day for each drug the oncologist provides.
 
For example, if the oncologist administers Adriamycin (J9000, Doxorubicin HCl, 10 mg) and 5 Fluorouracil (5FU) (J9190, Fluorouracil, 500 mg) on the same day, you could report 96408 for each administration.
 
In addition, Medicare increased payment for 96408, so you should expect roughly $155 per use. In 2003, the government paid only $38 when you submitted 96408.