Oncology & Hematology Coding Alert

Question: If the patient receives an infusion of Zofran over 30 minutes and then there is a piggyback of Dexamethasone for 15 minutes in the same bag, is the Dex considered a push or a concurrent infusion?


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Answer: The Dexamethasone administration is a push because it only took 15 minutes.

CPT defines a push as -a) an injection in which the healthcare professional who administers the substance/drug is continuously present to administer the injection and observe the patient, or b) an infusion of 15 minutes or less.-

What to do: Assuming the provider sets up a saline -flush bag,- connects the Zofran to the flush bag, and infuses the Zofran for 30 minutes and then pushes the Dex through the same flush bag, report:

- Zofran infusion--90765 (Intravenous infusion, for therapy, prophylaxis, or diagnosis [specify substance or drug]; initial, up to 1 hour)

- Zofran drug--J2405 (Injection, ondansetron HCl, per 1 mg)

- Dex push--+90775 (Therapeutic, prophylactic or diagnostic injection [specify substance or drug]; each additional sequential intravenous push of a new substance/drug)

- Dex drug--J1100 (Injection, dexamethasone sodium phosphate, 1 mg). Remember: Even if the Zofran and Dex run into the patient at the same time, this is not a concurrent infusion because the Dex admin is a push.