CPT^® 96413, Under Injection and Intravenous Infusion Chemotherapy and Other Highly Complex Drug or Highly Complex Biologic Agent Administration

The Current Procedural Terminology (CPT^®) code 96413 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

Chemotherapy is a therapeutic procedure used for the treatment of cancer via the use of chemical agents. These chemical agents (drugs) work on the cancerous cells of the body to destroy them. These drugs are administered into a number of body areas in methods such as oral, intramuscular, subcutaneous, intravenous, intra–arterial, intraventricular, intraperitoneal and topical. The intravenous method of chemotherapy is the most common as this way of drug delivery ensures faster absorption of the drugs into the blood stream.

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Blood draw during Infusion

During the Infusion procedure if blood is drawn for testing purpose, then can we bill 36415 or would that be considered inclusive with Infusion admin codes (96413/96365).... [ Read More ]

Infusion with hydration

[QUOTE="hsmith67, post: 513680, member: 92069"] Patient received infusion of Remicade. Remicade is administered with NS. Patient has Medicare Advantage plan. Do I bill: a) 96413/96415 based on time ... [ Read More ]

Infusion with hydration

Patient received infusion of Remicade. Remicade is administered with NS. Patient has Medicare Advantage plan. Do I bill: a) 96413/96415 based on time of infusion for the Remicade, or b) 96360/96361... [ Read More ]

BILLING 96374 WITH 96413 AND 96365

[QUOTE="simqueen, post: 508369, member: 44884"] CPT guidelines note that if you have one IV site, you can only have one initial service. So, if you have 96413 or 96365 for an infusion, 96374 is off ... [ Read More ]

BILLING 96374 WITH 96413 AND 96365

[QUOTE="mmathewscpc, post: 508338, member: 59394"] ok, 96413 and 96365 are initial infusion hour codes, 96374 is initial push of medication in an infusion, not the first hour....and 96375 is an add on... [ Read More ]

BILLING 96374 WITH 96413 AND 96365

ok, 96413 and 96365 are initial infusion hour codes, 96374 is initial push of medication in an infusion, not the first hour....and 96375 is an add on code, it's the additional push of same or differen... [ Read More ]

BILLING 96374 WITH 96413 AND 96365

You cannot bill 96374 with 96413 as they are initial codes per the AMA guidelines, you would need to bill 96375 with the 96413.... [ Read More ]

BILLING 96374 WITH 96413 AND 96365

i have read recently in the coding book for the 96374 code, that it is for short infusions, less than 15 minutes. my question is that when i bill my infusions with the admin codes to commercial as suc... [ Read More ]

Infusion coding for two drugs under one HCPCS

Two complex drugs in a combination (one HCPCS code) are each administered IV over 20 minutes, sequentially one right after the other via the same IV access point. Because it is one therapy (one HCPCS ... [ Read More ]

Provider Signatures

[QUOTE="stephmescher, post: 504825, member: 463714"] Can you explain what needs to be documented to support the "incident to" requirements? Also wondering if you can give some insight on the 96413- ar... [ Read More ]

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