Wiki Ip chemo

[krssy70]

We are having some issues billing for IP chemo therapy. Just wondering how other facilities are billing for these services. The procedure codes we are billing are 96446 along with 96375 for the additional pushes... The NCCI edits are rejecting these codes when billed together.

NEED HELP PLEASE!!!
Kristen

 

[librak1]

We bill this code in our office and have come to realize that you still need to have an initial code billed for that day. If you only have the pushes to bill along with the 96446, you would need one of those pushes to be a 96374 and the other a 96375. Also, check your NCCI to determine what codes will need modifiers when billed with 96446.
Hope this helps

 

[OCD_coder]

If you are giving the pushes through the 96446, they cannot be billed separately.

If you are giving the pushes for the therapeutic drugs into another hole into the patient either through a port or IV location. Then you need to have another primary code, such as 96374. We have to append Anthem claims with modifier 59 as they bundle even that.

Our offices do not give additional drugs into the IP port for the fact that insurance companies pay so much for the 96446 they consider all other IV infusions included inside of this code.

I hope this helps.

 

[krssy70]

I just want to make sure that you know that I am billing for a hopsital facility. I know that physician based billing would bill differently. But yes, your responses did help. We are realizing that when it is a separate anatomical site, then we can bill more than one initial. Thank you for your responses.