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CPT® 96409, Under Injection and Intravenous Infusion Chemotherapy and Other Highly Complex Drug or Highly Complex Biologic Agent Administration

The Current Procedural Terminology (CPT®) code 96409 as maintained by American Medical Association, is a medical procedural code under the range - Injection and Intravenous Infusion Chemotherapy and Other Highly Complex Drug or Highly Complex Biologic Agent Administration.

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Summary

In this procedure, the provider administers the chemotherapy drug using an intravenous push technique. Use this code when the provider administers a single or initial drug.

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Have a question about CPT Code 96409 ? Start a discussion here
Facility outpatient infusion clinic coding
[QUOTE="thomas7331, post: 497840, member: 5404"] In addition to the guidance in CPT I quoted above, you can find it in the NCCI Policy Manual, Chapter 11, Section B, Paragraph 2: [I]CPT codes 96360, ... [ Read More ]
Facility outpatient infusion clinic coding
[QUOTE="AlisiaJ, post: 497836, member: 445531"] I see what you mean why that would be confusing. The argument I am receiving is only two admins can be charged if there are two different access sites r... [ Read More ]
Billing J9201 Gemcitabine and Admin Code 51720 to Medicare
I’m reaching out to see if there is any additional help or resources regarding the Gemcitabine J9201 and billing to Medicare for bladder cancer. We are currently using this drug and billing with the... [ Read More ]
cpt 96402
Medicare says, "Codes 96401-96402, 96409-96425, 96521-96523 are not intended to be reported by the individual physician or other qualified health care professional in the facility setting. " I am con... [ Read More ]
Inpatient pediatric consults
[QUOTE="tammym7797, post: 458998, member: 611619"] Do pediatric consults (inpatient) get paid by most insurance companies? What if a pediatrician is consulted to hospital and only monitors IV antibio... [ Read More ]
Auditor states drug ordered as IV over 2 minutes must have a doc stop time?
When its just an IV PUSH there does not need to be a stop time. If it truly was an IV drug hung for say 20 minutes yes there would need to be start and stop times but the PUSH IV drugs do not need t... [ Read More ]
96413 vs 96409 with 96368
Hello! This is my first time using this so I apologize if I'm doing it wrong. We have received denials for the use of 96368 when billing with 96409 as the primary CPT Code. I have discussed with our c... [ Read More ]
Physician Infusion Services, CHONC Practice Exam Clarification.
[QUOTE="dtricia, post: 440281, member: 51425"]My CPT book says 96375 is add on only to 96365, 96374, 96409,96413. it should not be added on to hydration. I was always taught that the therapeutic drug... [ Read More ]
Physician Infusion Services, CHONC Practice Exam Clarification.
[b]using 96375 as add on to hydration[/b] My CPT book says 96375 is add on only to 96365, 96374, 96409,96413. it should not be added on to hydration. I was always taught that the therapeutic drugs o... [ Read More ]
Concurrent Infusion scenario help
I agree with Ajesh Kuriakose I will report 96409,96775x2, 96367x2, 96366 .... [ Read More ]
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