Wiki Billing for infusion reaction medications

[rmoore75@gmail.com]

We have a patient that had several reactions during a Rituxan (1g) infusion and I've run into some issues with trying to bill it out to Medicare. She was able to finish the full infusion so I'm fine on that part, but the pre- and reaction meds are tripping me up.

Any advice/insight would be appreciated!

Timeline:

J2919 (125mg vial) 100mg Start: 0835 Stop: 0838 Waste 25 mg
J1200 25mg Start: 0839 Stop: 0842 Waste 25 mg

J9312 Start: 0912 Stop: 1001

J1200 50mg Start: 1003 Stop: 1006 Waste 0
S0028 (J3490) 20mg Start: 1007 Stop: 1010 Waste 0
J2919 (40mg vial) Start: 1018 Stop: 1021 Waste 0

J9312 Start: 1214 Stop: 1348

J1200 50mg Start: 1352 Stop: 1355 Waste 0
J2919 (40mg vial) 80mg Start: 1400 Stop: 1403 Waste 0
S0028 (J3490) 20mg Start: 1407 Stop: 1410 Waste 0

J9312 Start: 1436 Stop: 1647

 

[trarut]

Can you be more specific about what problem you're having? I can imagine a few things you may be questioning but don't want to guess

 

[rmoore75@gmail.com]

Can you be more specific about what problem you're having? I can imagine a few things you may be questioning but don't want to guess

It is mostly modifier usage and how many individual lines should be billed for the reaction medications and the administration codes. The time between administration of each medication were greater than 30 minutes, so each IVP should get it's own administration code, right?

This is how I think it should be billed:
J2919 (125mg vial) - 20 units
J2919-JW (125mg vial) - 5 units
J1200-JZ - 1 unit

J1200-JZ - 1 unit
J2919 (40mg vial) - 16 units
J3490-JZ - 1 unit

J1200-JZ - 1 unit
J2919 (40mg vial) - 16 units
J3490-JZ - 1 unit

96375 - 3 units
96376 - 5 units