Oncology & Hematology Coding Alert

Question: When Medicare patients receive an intravenous dose of ondansetron after a chemotherapy infusion session, may we report the ondansetron separately from the chemotherapy?

Wyoming Subscriber

Answer: Yes, you may report the ondansetron separately when you administer it post-chemo.
 
If you give a Medicare patient chemotherapy first (58-minute session), then administer the ondansetron, you should report:

- 96413 -- Chemotherapy administration, intravenous infusion technique; up to one hour, single or initial substance/drug

- +90775 -- Therapeutic, prophylactic or diagnostic injection (specify substance or drug); each additional sequential intravenous push of a new substance/drug (list separately in addition to code for primary procedure).

If you bear the cost of the drug, you should report it with the code for intravenous, not oral, ondansetron (Zofran), J2405 (Injection, ondansetron HCl, per 1 mg).