Wiki Intrathecal chemotherapy via Ommaya reservoir

[kseverson]

How would you code this?
Ommaya reservoir was accessed with a 25 gauge butterfly, and 4 cc of clear CSF were removed and sent for studies. (this is done to balance the fluids we are injecting by pulling some fluid out prior to maintain the correct pressure and then this is sent for testing). Chemotherapy is then given into the Ommaya reservoir.
Would you select 1,2 or 3
1) 96542, 61070
2) 96542, 61020
3) 96542
Or something different?

Thank you!

 

[simqueen]

3 - 96542 only. This is a drug administration service and the accessing of the Ommaya is included in the drug/chemo administration service, just like starting an IV or accessing a port is included. There is an NCCI edit that triggers for the combination of 96542 and 61070, so to report together, the puncture would have to be separate and distinct from the chemotherapy administration. CPT 61020 states "without injection" and would not be appropriate in this scenario.

 

[kseverson]

3 - 96542 only. This is a drug administration service and the accessing of the Ommaya is included in the drug/chemo administration service, just like starting an IV or accessing a port is included. There is an NCCI edit that triggers for the combination of 96542 and 61070, so to report together, the puncture would have to be separate and distinct from the chemotherapy administration. CPT 61020 states "without injection" and would not be appropriate in this scenario.

Thanks!

 

[bicyclegal]

How would you code this?
Ommaya reservoir was accessed with a 25 gauge butterfly, and 4 cc of clear CSF were removed and sent for studies. (this is done to balance the fluids we are injecting by pulling some fluid out prior to maintain the correct pressure and then this is sent for testing). Chemotherapy is then given into the Ommaya reservoir.
Would you select 1,2 or 3
1) 96542, 61070
2) 96542, 61020
3) 96542
Or something different?

Thank you!

61210 is what I code for Ommaya

 

[kseverson]

61210 is what I code for Ommaya

I believe 61210 is for the actual placement of the device. We aren't the ones placing the device. We are removing some cerebral spinal fluid through the device, and then injecting chemotherapy into the device.