Wiki 96368 with 96366

[mjm41795]

Can you bill a 96368 (1unit) and a 96366 (1unit) for the concurrent infusion of Leucovorin which is given over 2 hours?

 

[OCD_coder]

Yes. We add a 59 modifier to the 96368 as insurance companies bundle it into the chem-infusion codes.

As long as the times overlap the times that the chemo is given, and the route is different than the chemo - meaning the drug is going into a different hole into the patient. This is a concurrent infusion. Usually you will see it documented similarly like this.

Example:
5FU 12:00pm start 14:15pm stop (96413, 96415)
Leucovorin 12:00pm start 14:15pm stop (96368, 96366)

If either infusion ran to 14:31, then an additional hour could be added 96415 w. chemo, 96366 for the Leucovorin.

Hope that helps.

 

[mjm41795]

Very helpful, that is what I thought, but the CPT book is confusing when it states under 96368 "report 96368 in conjunctino with 96365, 96366, 96413, 96415, 96416" but under 96366 in states "report 96366 in conjunction with 96365, 96367"

Thank you for clearing it up for me