Wiki Home pump billing

[dtricia]

Our Lynx dispenses the 5FU, some is given IVP, the rest home in pump. I think the 5FU that is infused at home should be billed POS 12, along with the pump rental. My current employere does not bill for pump rental.
How are others dealing with this? In my previous employment, I kept a spreadsheet of the dates of 96416 and 96521and how much 5FU the patient got and billed it cummulatively at month end along with the E0781. Here that would never happen.
Tricia D

 

[alannae]

I don't have a reference to support this but this is my understanding/reasoning for billing with POS 11.

The 5FU is billed with POS 11 because the drug is being dispensed in the office. This is where the 'work' is done. The pump is set up in the office and it is billed with this place of service even though a portion of the infusion will occur outside the office (at the patient's home, in their car, at the store, at the movies, etc).

Have you had experience in billing the 5FU with POS 12? We had tried that many years ago thinking that it made sense since we were billing for the DME (E0781) with POS 12 as well. It was a nightmare for us. The insurance companies only expected that to happen if the drug is dispensed/given by a home health agency. It caused all kinds of issues.