Wiki disconnect for prolonged infusion pump

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trarut

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Looking for input from community oncology practices on pump disconnects. We're having conversations about process changes and would like to know what others are doing.

  1. Prolonged infusion pump disconnects on Saturdays: I'm interested in hearing anything you can share about your processes, but am specifically curious about if you have a physician on-site Saturdays? I can't find a definite answer on whether a pump disconnect is direct or general supervision. I can make an argument both ways from what I've read. I don't expect documentation will be any different from what we do now Monday-Friday.
  2. Patient self-disconnects of prolonged infusion pumps: Definitely looking to hear from any practices doing this. When and how do you capture the disconnect time for your MAR? Is your documentation for the connect or disconnect any different for these scenarios?
I appreciate any info you can share. TIA!
 
The physician fee schedule indicates that 96416 is an incident to code, which means direct supervision. We know from the 2024 Final Rule that direct supervision may be provided via interactive audio/video. Per CMS in previous transmittals back in 2016, G0498 is considered incident to the services that are started in the physician office/clinic. Therefore they would also require direct supervision.

Couldn't tell you about patient self-disconnects, but I can say that you really can't bill for something the patient does. CPT and HCPCS codes are valued for physician and/or clinical staff work.
 
rachaelwilleford said:
The physician fee schedule indicates that 96416 is an incident to code, which means direct supervision. We know from the 2024 Final Rule that direct supervision may be provided via interactive audio/video. Per CMS in previous transmittals back in 2016, G0498 is considered incident to the services that are started in the physician office/clinic. Therefore they would also require direct supervision.

Couldn't tell you about patient self-disconnects, but I can say that you really can't bill for something the patient does. CPT and HCPCS codes are valued for physician and/or clinical staff work.
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Thanks Rachael. I agree and I have been the squeaky wheel in this conversation in our office about these issues. Portable pump services aren't a problem but these aren't a "normal" situation. Patient self-disconnects are becoming more common but there is no guidance available with regards to the proper handling of the documentation and billing.
 
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