Practice Management Alert

Question: Our physician administered three drug substances via one infusion. With all the recent infusion and injection changes, I-m not sure how to bill for this. Would you tell me what codes I should be submitting?


Idaho Subscriber

Answer: CPT intends for you to separately report a new chemotherapy or infusion/injection code for each method and route of administration. Therefore, you would not report three separate infusion services if the patient receives one infusion consisting of three substances in a single bag, CPT Changes says.

How it works: The 2006 codes reimburse based on the additional work required for each separate administration. For additional drugs administered through the same route, you can use subsequent, sequential or concurrent codes.

Here are the codes you have to choose from (and which one you choose depends on the type of substance and method of administration): 

-  90760--Intravenous infusion, hydration; initial, up to 1 hour

- +90761--... each additional hour, up to 8 hours (list separately in addition to code for primary procedure)

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

- +90767--... additional sequential infusion, up to 1 hour

- +90768--... concurrent infusion

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

- +96411--Chemotherapy administration; intravenous, push technique, each additional substance/drug

- 96413--Chemotherapy administration, intravenous infusion technique; up to 1 hour, single or initial substance/drug

-+96417--... each additional sequential infusion (different substance/drug), up to 1 hour.

Example: A patient receives an anti-emetic drug during a 75-minute IV infusion, following the initiation of a chemotherapy IV infusion that also lasts 75 minutes. During the same treatment session, the patient also receives a second dose of the anti-emetic drug via an IV push.

You would report the initial chemotherapy infusion with 96413, then report sequential IV infusion code 90767 for the anti-emetic drug infusion, followed by IV push administration code 90775 for the additional anti-emetic push, CPT Changes says.