CPT^® 96415, Under Injection and Intravenous Infusion Chemotherapy and Other Highly Complex Drug or Highly Complex Biologic Agent Administration

The Current Procedural Terminology (CPT^®) code 96415 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 add on procedure, the provider continues administration of a chemotherapy drug into a vein using an infusion technique. He uses this code to report each additional hour of infusion beyond the initial hour, which the patient receives at the same session.

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Forum

Have a question about CPT Code 96415 ? Start a discussion here

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

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 ]

Infusions

Hi everyone I was asked to reach out to other gastro coders who do infusion coding. What infusion codes (for Entyvio) are you using, and getting paid for, when billing Medicare and United? We were b... [ Read More ]

Infliximab billing with a non chemo diagnosis code

When billing Medicare for J1745 with a non chemo diagnosis do we use a chemo administration charge 96413, 96415 or 96417 or wound we use IV infusion for therapy administration charge 96365 etc.?... [ Read More ]

Billing for infusion admin codes

96415 is billable once 31 minutes of the second or subsequent hours is reached. For example: 90 minute infusion = 96413 only 91 minute infusion = 96413 + 96415 120 minute infusion = 96413 + 96415 ... [ Read More ]

Billing for infusion admin codes

When billing 96415, do you bill it in increments of 30 minutes or as an hour? For instance, if a patient is in the chair for 2 hours, 96413 would be billed for the first hour but how would you bill fo... [ Read More ]

96415

Has anyone else had issues with insurance companies denying 96415?... [ Read More ]

I am doing Chemo coding and have three 96417, i am a little confused, should this be only coded once as stated in CPT ?

The starting rule with chemo/infusion billing is that you use only 1 code noted as "initial" per visit and the additional drug infusions are coded as sequential. If you are new to chemo coding, you s... [ Read More ]

I am doing Chemo coding and have three 96417, i am a little confused, should this be only coded once as stated in CPT ?

How do i code 96417 in Chemo coding, If I have three different infusions ? Do not understand the part about using it only once then using 96415.... [ Read More ]

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