Oncology & Hematology Coding Alert

Question: If a non-Hodgkin's lymphoma patient has an adverse reaction to Rituximab less than 15 minutes into the ordered hour-long infusion, should I report a push?Georgia SubscriberAnswer: Experts suggest the most appropriate way to report a discontinued infusion is to append modifier 53 (Discontinued procedure) to the appropriate chemotherapy infusion code, such as 96413 (Chemotherapy administration,intravenous infusion technique; up to 1 hour, single or initial substance/drug).You should use modifier 53 when a physician stops a procedure "due to extenuating circumstances or those that threaten the well-being of the patient," according to CPT.Modifier 53 describes an unexpected problem, beyond the physician's or patient's control, that necessitates ending the procedure. The physician doesn't elect to discontinue the procedure as much as he is forced to do so because of the circumstances.Push: CPT guidelines include "an infusion of 15 minutes or less" as one definition of a push, but 96413-53 describes the ordered [...]