CPT^® 96417, Under Injection and Intravenous Infusion Chemotherapy and Other Highly Complex Drug or Highly Complex Biologic Agent Administration

The Current Procedural Terminology (CPT^®) code 96417 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 administration of a different chemotherapy drug through the intravenous infusion following the administration of a primary dose of chemotherapy.

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View matching HCPCS Level II codes and their definitions.

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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 ]

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 ]

Infusion Question

[QUOTE="shanamarie, post: 494898, member: 394418"] We have a patient that the nurses are wanting to combine 2 infusion services into one visit. The patient would have IVIG (J1561) run over 2.5-3hours... [ Read More ]

Avastin - Leucovorin

Leucovorin billing for 2020 Leucovorin - 1120-1220 - 1hr infu Avastin - 1048-1118 - 30mins 5FU-push Shall we code this as: 96413 - avastin, 96417 - Leucovorin or Leucovorin still be coded as 96367? P... [ 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 ]

Billing Chemotherapy Drugs

I have 2 questions I would like some clarity on based on correct billing guidelines for Chemotherapy drugs: 1. Is there a payable HCPCS chemotherapy drug list anywhere? I have searched high and low. ... [ Read More ]

Chemotherapy Coding and billing Administrative and HCPC Codes

When billing a chemotherapy claim do I stager the Administration code with the corresponding HCPC Code or can I list all J codes first then Administration codes after? Also do the HCPC Codes need to b... [ Read More ]

Coding Hierarchy

IF you have 2 chemo drugs being infused, you need to know the times of infusion for all, including the magnesium. Let's say both chemo drugs were 1 hour long, you would code 96413 & 96417 and if the m... [ Read More ]

Billing for INR. Billing for 96417.

[b]INR /Pt[/b] [QUOTE="Robert5131, post: 345575, member: 320443"]I have patients coming into the office and I am billing 36416 and 85610. We have an active CLIA number. I keep getting denials for mod... [ Read More ]

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