Oncology & Hematology Coding Alert

Question: If a patient sees the physician and the physician bills for a blood draw and then recommends the port flush, can I report this as well if the patient does not have an infusion?

Mississippi Subscriber

Answer: In the CPT 2008 handbook, a new note under port flush code 96523 (Irrigation of implanted venous access device for drug delivery systems) says, "Do not report 96523 if any other services are provided on the same day."

Why not? "Because irrigation of a venous access device has minimal effort associated with its provision, this code should only be reported for those instances when no other service (e.g., evaluation and management, chemotherapy) has been provided," explains CPT 2008 Changes: An Insider's View.

If a physician performs a blood draw (e.g., 36415, Collection of venous blood by venipuncture) and recommends a port flush, you can only report it if it is the only "physician" service provided on that day. You cannot report it with an E/M service.