Oncology & Hematology Coding Alert

Question: I understand that I can't bill a port flush on the same date as chemotherapy infusion, but may I report a port flush on the same date as an office visit?

Oklahoma Subscriber

Answer: You should not report a port flush on a date when your practice provides the patient any other service, including E/M services.

CPT® Changes 2008: An Insider's View states, "because irrigation of a venous access device has minimal effort associated with its provision," you should report 96523 (Irrigation of implanted venous access device for drug delivery systems) only "when no other service (e.g., evaluation and management, chemotherapy) has been provided."

Similarly, Medicare instructs contractors to include 96523 in the payment for a "visit": "Pay for code 96523... if it is the only service provided that day. If there is a visit or other chemotherapy administration or nonchemotherapy injection or infusion service provided on the same day, payment for 96523 is included in the payment for the other service" (Medicare Claims Processing Manual, Chapter 12, Section 30.5.E).