Oncology & Hematology Coding Alert

Question: The physician has recently performed an ommaya tap with chemo on a hospitalized patient. What would be the correct CPT® code for a non-hospital physician performing these services in the hospital?

Codify Member

Answer: You should report the same code whether the physician performs the service in the office or in the hospital: 96542 (Chemotherapy injection, subarachnoid or intraventricular via subcutaneous reservoir, single or multiple agents).

Although CPT® guidelines indicate most of the chemotherapy infusion codes aren't "intended to be reported by the physician in the facility setting," the guidelines indicate 96542 is one of the exceptions.